| 王 运,李林法,庞伟强.18F-FDG PET/CT半定量参数在肾上腺病灶鉴别诊断中的价值[J].肿瘤学杂志,2019,25(6):547-551. |
| 18F-FDG PET/CT半定量参数在肾上腺病灶鉴别诊断中的价值 |
| The Value of Semi-quantitative Parameters of 18F-FDG PET/CT in the Differential Diagnosis of Adrenal Lesions |
| 投稿时间：2018-09-26 |
| DOI：10.11735/j.issn.1671-170X.2019.06.B011 |
|
 |
| 中文关键词: 肾上腺病灶 标准化摄取值 18F-FDG 正电子发射型体层摄影术 |
| 英文关键词:adrenal lesion SUV 18F-FDG positron-emission tomography |
| 基金项目:国家卫生计生委科学研究基金?鄄浙江省医药卫生重大科技计划（WKJ-ZJ-1814） |
|
| 摘要点击次数: 1793 |
| 全文下载次数: 327 |
| 中文摘要: |
| 摘 要：［目的］ 探讨18F-FDG PET/CT半定量参数在鉴别肾上腺病灶中的价值。［方法］ 对90例疑有肾上腺疾病患者的18F-FDG PET/CT检查结果进行分析。利用半定量分析法，测量所有病灶的T/L SUVmax、SUVmax、肿瘤直径和平均CT值，与最终病理结果比较。［结果］ 共检出110个病灶，其中恶性肾上腺病灶51例、良性肾上腺病灶39例。恶性肾上腺病灶的平均T/L SUVmax（2.9±1.6）、SUVmax（8.3±5.1）、肿瘤直径（3.1cm±1.6cm）和平均CT值（31.9±7.0Hu）较良性病灶的平均T/L SUVmax（0.9±0.5）、SUVmax（2.7±1.4）、肿瘤直径（2.1cm±1.7cm）和平均CT值（12.1±17.5Hu）显著升高（P均<0.001）。假阳性3例、假阴性2例。ROC曲线分析显示，T/L SUVmax>1.15、SUVmax>3.86、CT值>23.5Hu和肿瘤直径>2.35cm可作为鉴别良恶性肾上腺病灶的最佳截断值。此最佳截断值的ROC曲线下的面积分别为0.95、0.95、0.84和0.76。多变量Logistic回归分析表明T/L SUVmax、SUVmax可作为恶性肾上腺病灶的独立诊断因素（P<0.001）。 ［结论］ 当T/L SUVmax>1.15、SUVmax>3.86时，18F-FDG PET/CT在鉴别肾上腺病灶性质中具有较高价值。T/L SUVmax、SUVmax均可作为预测恶性病灶的独立因素，且T/L SUVmax更为客观。 |
| 英文摘要: |
| Abstract：［Objective］ To evaluate the value of semi-quantitative parameters of 18F-FDG PET/CT for the differentiation of malignant from benign adrenal lesions. ［Methods］ Included 90 patients (58 men and 32women，age 60.1±11.6 year) who had undergone 18F-FDG PET/CT for evaluation of 110 adrenal lesions. For semi-quantitative analysis，adrenal to liver(T/L) SUVmax ratio，the maximum standardized uptake value(SUVmax)，tumor diameter and mean CT attenuation value were measured in all lesions and compared with the pathological findings. ［Results］ A total of 110 lesions were detected，including 51 malignant and 39 benign. Malignant adrenal masses had a significantly higher T/L SUVmax ratio (2.9±1.6 vs. 0.9±0.5)，a higher mean SUVmax (8.3±5.1 vs. 2.7±1.4)，a greater tumor diameter (3.1±1.6cm vs. 2.1±1.7cm) and a higher mean CT attenuation value (31.9±7.0Hu vs. 12.1±17.5Hu) than benign lesions(P<0.001). There were three false positives and two false negatives. Based on ROC curve analysis，a T/L SUVmax ratio >1.15，an adrenal SUVmax>3.86，an attenuation value >23.5 Hu and a tumor diameter >2.35 cm were chosen as the optimal cut-off values for differentiating malignant from benign adrenal masses. The areas under the ROC curves for the selected cut-off values were 0.95，0.95，0.84 and 0.76，respectively. A multivariate logistic regression model revealed that the T/L SUVmax and SUVmax were an independent prognostic factor for malignancy(P<0.001)；a CT attenuation value of >23.5 Hu and a tumor diameter >2.35 cm had no additional individual importance in the diagnosis of malignancy. ［Conclusion］ Using a T/L SUVmax ratio >1.15 and an adrenal SUVmax >3.86 in 18F-FDG PET/CT led to high diagnostic sensitivity，accuracy and positive predictive value for characterizing adrenal lesions. T/L SUVmax and SUVmax could be used as independent predictors of malignancy，however，the T/L SUVmax is more objective. |
|
在线阅读
查看全文 查看/发表评论 下载PDF阅读器 |