CAJ | 학술논문

目的分析良恶性腹腔积液患者18 F-FDG PET/CT显像特点,探讨腹腔积液SUV对不明原因腹腔积液的辅助诊断价值.方法回顾性分析首次18 F-FDG PET/CT检查前病因不明、但随访诊断明确的腹腔积液患者55例,其中男24例,女31例,年龄23～82(平均54.8)岁;良性腹腔积液19例,恶性腹腔积液36例.测定良恶性腹腔积液的SUV,并计算其与正常肝脏SUV的比值(T/NT).比较PET/CT肿瘤定位诊断、腹腔积液代谢判定及细胞学检查三者的诊断效能.采用两样本t检验、x2检验或确切概率法分析数据.结果恶性腹腔积液患者18F-FDG PET/CT显像示腹腔积液代谢升高,MIP图像呈肝脾“淹没征”.恶性腹腔积液的SUVmax及SUVmax.分别为1.78±0.65和1.37±0.38,良性腹腔积液的相应值分别为1.11 ±0.36和0.72±0.22,前者明显高于后者(t=4.13、6.82,均P＜0.05).恶性腹腔积液的T/NT值明显高于良性腹腔积液(基于SUVmax的T/NT值:0.64±0.20与0.48±0.12,t=3.27;基于SUVmean.的T/NT值:0.68±0.17与0.38±0.10,t=7.21,均P＜0.05).根据腹腔积液代谢诊断恶性腹腔积液的灵敏度、特异性及准确性分别为75.0％(27/36)、94.7％(18/19)和81.8％(45/55),其灵敏度及准确性明显高于腹腔积液细胞学检查[44.4％(16/36)与63.6％(35/55);X2=6.98和4.58,均P＜0.05],其特异性明显高于PET/CT肿瘤定位诊断[63.2％ (12/19)X2=5.70,P＜0.05].结论腹腔积液代谢升高对恶性腹腔积液的辅助诊断具有重要价值,18 F-FDG PET/CT阅片分析应密切结合腹腔积液SUV及与肝脏的T/NT值,以进一步提高对不明原因腹腔积液的良恶性鉴别诊断效率.
목적 분석량악성복강적액환자18 F-FDG PET/CT현상특점,탐토복강적액SUV대불명원인복강적액적보조진단개치.방법 회고성분석수차18 F-FDG PET/CT검사전병인불명、단수방진단명학적복강적액환자55례,기중남24례,녀31례,년령23～82(평균54.8)세;량성복강적액19례,악성복강적액36례.측정량악성복강적액적SUV,병계산기여정상간장SUV적비치(T/NT).비교PET/CT종류정위진단、복강적액대사판정급세포학검사삼자적진단효능.채용량양본t검험、x2검험혹학절개솔법분석수거.결과 악성복강적액환자18F-FDG PET/CT현상시복강적액대사승고,MIP도상정간비“엄몰정”.악성복강적액적SUVmax급SUVmax.분별위1.78±0.65화1.37±0.38,량성복강적액적상응치분별위1.11 ±0.36화0.72±0.22,전자명현고우후자(t=4.13、6.82,균P＜0.05).악성복강적액적T/NT치명현고우량성복강적액(기우SUVmax적T/NT치:0.64±0.20여0.48±0.12,t=3.27;기우SUVmean.적T/NT치:0.68±0.17여0.38±0.10,t=7.21,균P＜0.05).근거복강적액대사진단악성복강적액적령민도、특이성급준학성분별위75.0％(27/36)、94.7％(18/19)화81.8％(45/55),기령민도급준학성명현고우복강적액세포학검사[44.4％(16/36)여63.6％(35/55);X2=6.98화4.58,균P＜0.05],기특이성명현고우PET/CT종류정위진단[63.2％ (12/19)X2=5.70,P＜0.05].결론 복강적액대사승고대악성복강적액적보조진단구유중요개치,18 F-FDG PET/CT열편분석응밀절결합복강적액SUV급여간장적T/NT치,이진일보제고대불명원인복강적액적량악성감별진단효솔.
Objective To explore the value of SUV in patients with ascites of unknown cause.Methods A total of 55 patients (24 males,31 females,average age 54.8 years,age range:23-82 years) with ascites of unknown cause who underwent 18F-FDG PET/CT scan were retrospectively enrolled in this study.SUVmax and SUVmean of ascites and liver were measured and their ratios (T/NT) were calculated and compared by two-sample t test.All patients were followed up and had final diagnoses.Sensitivity,specifici ty,accuracy,positive predictive value and negative predictive value were calculated respectively.The diagnostic efficiency was compared among 18F-FDG PET/CT tumor localization alone,ascites radioactivity and ascites cytology examination by x2 test or Fisher exact test.Results Besides the high metabolized primary lesions and/or metastasis,the liver and spleen swamped by ascites with high radioactivity were visualized on MIP images.The SUVmax and SUVmean of malignant ascites were 1.78±0.65 and 1.37±0.38 respectively,which were higher than those of benign ascites (1.11±0.36 and 0.72±0.22; t=4.13,6.82,both P＜0.05).T/NT of malignant ascites was higher than that of benign ascites (SUVmax:0.64±0.20 vs 0.48±0.12,t =3.27,SUVmeax:0.68±0.17 vs 0.38±0.10,t =7.21 ; both P＜0.05).The diagnostic sensitivity,specificity and accuracy of SUV in ascites were 75.0％ (27/36),94.7％ (18/19) and 81.8％ (45/55),respectively.The sensitivity and accuracy of SUV were higher than those of cytological examination (44.4％ (16/36) and 63.6％ (35/55) ; x2 =6.98,4.58,both P＜0.05).The specificity of SUV was higher than that of tumor localization by 18F-FDG PET/CT (63.2％,12/19; x2 =5.70,P＜0.05).Conclusion Significantly higher SUVmax and SUV in malignant ascites than benign ascites were noted,which might play an adjuvant role in patients with ascites of unknown cause.