CAJ | 학술논문

目的：探讨双时相18F-脱氧葡萄糖（FDG）PET/CT显像对早期SUVmax≤2.5的低代谢孤立性肺结节（SPN）的诊断价值。方法：回顾性分析2011年9月-2013年6月在我院诊断为SPN且PET/CT早期显像SUVmax值≤2.5的45例患者的临床资料。45例患者中男27例，女18例，平均年龄为（59.71±11.42）岁。所有患者注射显像剂后60 min行PET/CT早期显像，120 min后行延迟显像。以半定量方法测定结节早期及延迟期SUVmax值，并计算延迟显像与早期显像SUVmax的差值（△SUVmax）。以△SUVmax≥0为阳性判断标准对结节进行定性诊断，计算其诊断的灵敏度、特异性、准确性，并绘制受试者工作特征（ROC）曲线以分析其诊断低代谢SPN的效能。结果：良恶性结节间的早期、延迟期SUVmax平均值差异均无统计学意义（t=0.193， P=0.848；t=1.452，P=0.154）；恶性结节的平均△SUVmax值较良性结节显著增加，差异有统计学意义（t=2.738， P=0.009）。以△SUVmax≥0为阳性判断标准诊断低代谢SPN的灵敏度、特异性、准确性、阳性预测值及阴性预测值分别为87.88%、66.67%、82.22%、87.88%及66.67%。△SUVmax诊断低代谢SPN的ROC曲线下面积为0.861。结论：双时相PET/CT显像延迟期与早期显像的SUVmax差值（△SUVmax）诊断低代谢SPN的灵敏度及阳性预测值较高，对于早期SUVmax≤2.5且无典型形态学特征的SPN，建议常规行双时相PET/CT检查以鉴别。
목적：탐토쌍시상18F-탈양포도당（FDG）PET/CT현상대조기SUVmax≤2.5적저대사고립성폐결절（SPN）적진단개치。방법：회고성분석2011년9월-2013년6월재아원진단위SPN차PET/CT조기현상SUVmax치≤2.5적45례환자적림상자료。45례환자중남27례，녀18례，평균년령위（59.71±11.42）세。소유환자주사현상제후60 min행PET/CT조기현상，120 min후행연지현상。이반정량방법측정결절조기급연지기SUVmax치，병계산연지현상여조기현상SUVmax적차치（△SUVmax）。이△SUVmax≥0위양성판단표준대결절진행정성진단，계산기진단적령민도、특이성、준학성，병회제수시자공작특정（ROC）곡선이분석기진단저대사SPN적효능。결과：량악성결절간적조기、연지기SUVmax평균치차이균무통계학의의（t=0.193， P=0.848；t=1.452，P=0.154）；악성결절적평균△SUVmax치교량성결절현저증가，차이유통계학의의（t=2.738， P=0.009）。이△SUVmax≥0위양성판단표준진단저대사SPN적령민도、특이성、준학성、양성예측치급음성예측치분별위87.88%、66.67%、82.22%、87.88%급66.67%。△SUVmax진단저대사SPN적ROC곡선하면적위0.861。결론：쌍시상PET/CT현상연지기여조기현상적SUVmax차치（△SUVmax）진단저대사SPN적령민도급양성예측치교고，대우조기SUVmax≤2.5차무전형형태학특정적SPN，건의상규행쌍시상PET/CT검사이감별。
Objective:To evaluate the role of dual time point 18F-FDG PET/CT imaging in diagnosis of solitary pulmonary nodule (SPN) with low metabolism. MethodDuring August 2011 to June 2013, forty-ifve patients conifrmed with SPN and SUVmax≤2.5 at early PET/CT imaging were retrospectively analysed (male 27, female 18, mean age 59.71±11.42 years). All patients were performed with early and delayed PET/CT imag-ing at 60 min and 120 min after intravenous injection respectively. The eraly and delayed maximum standardized uptake value (SUVmax) of PET/CT imaging were measured and the change of SUVmax (△SUVmax) was cal-culated. The sensitivity, speciifcity and accuracy were calculated using the△SUVmax≥0 as diagnostic positive standard, and the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic vale of△SU-Vmax for low metabolic SPN. ResultThe differences in average SUVmax of early and delayed imaging be-tween benign and malignant nodules had no statisticly signiifcance (t=0.193, P=0.848, t=1.452, P=0.154). There was signiifcant difference in mean△SUVmax between malignant and benign lesions (t=2.738, P=0.009). The sensitivity, speciifcity, accuracy, positive predictive value and negative predictive value were 87.88%, 66.67%, 82.22%, 87.88%and 66.67%respectively with△SUVmax≥0 as diagnostic positive standard. The area under ROC curve was 0.861 according to the△SUVmax. Conclusion:The dual time point PET/CT imaging is use-ful for differentiating solitary pulmonary nodules with early SUVmax≤2.5 and without speciifc morphological characteristics.