北京大学学报(医学版)
北京大學學報(醫學版)
북경대학학보(의학판)
JOURNAL OF BEIJING MEDICAL UNIVERSITY(HEALTH SCIENCES)
2015年
1期
175-180
,共6页
康磊%徐小洁%范岩%王荣福%马超%付占立%张建华%张旭初
康磊%徐小潔%範巖%王榮福%馬超%付佔立%張建華%張旭初
강뢰%서소길%범암%왕영복%마초%부점립%장건화%장욱초
发热,原因不明%氟脱氧葡萄糖F18%正电子发射断层显像术
髮熱,原因不明%氟脫氧葡萄糖F18%正電子髮射斷層顯像術
발열,원인불명%불탈양포도당F18%정전자발사단층현상술
Fever of unknown origin%Fluorodeoxyglucose F18%Positron-emission tomography
目的:评价18 F-FDG PET/CT显像在不明原因发热( fever of unknown origin ,FUO)诊断中的临床价值。方法:回顾分析2010年8月至2013年4月的51例FUO病例的FDG PET/CT检查结果。依据病理学、实验室检查或临床随访(大于3个月)得出最终病因诊断,通过定性及半定量方法对FDG PET/CT的诊断结果进行评价,统计学分析采用组间t检验。结果:51例FUO患者的最终诊断包括感染32例、恶性肿瘤9例、非感染性炎症7例以及不明原因3例。单独FDG PET显像对FUO的诊断结果中,真阳性27例(52.9%),假阳性14例(27.5%),假阴性9例(17.6%),真阴性1例(2.0%)。相比之下,联合PET和CT检查的PET/CT显像诊断结果中,真阳性36例(70.6%),假阳性14例(27.5%),假阴性1例(2.0%),真阴性0例(0)。 PET/CT诊断的灵敏度为97.3%(36/37),特异性为0(0/14),准确度为70.6%(36/51)。针对恶性肿瘤,PET或PET/CT的诊断灵敏度及准确度均达100.0%(9/9)。感染与恶性肿瘤病灶的最大标准化摄取值( maximum standardized uptake value ,SUVmax)之间差异有统计学意义(3.7±2.7 vs.7.7±3.5,P=0.001,t=3.6),提示SUVmax可能有助于发热病因的鉴别诊断。结论:FDG PET/CT不但能够在全身范围内发现、定位导致发热的潜在病灶,而且有助于FUO的病因诊断,特别是对恶性肿瘤的诊断。
目的:評價18 F-FDG PET/CT顯像在不明原因髮熱( fever of unknown origin ,FUO)診斷中的臨床價值。方法:迴顧分析2010年8月至2013年4月的51例FUO病例的FDG PET/CT檢查結果。依據病理學、實驗室檢查或臨床隨訪(大于3箇月)得齣最終病因診斷,通過定性及半定量方法對FDG PET/CT的診斷結果進行評價,統計學分析採用組間t檢驗。結果:51例FUO患者的最終診斷包括感染32例、噁性腫瘤9例、非感染性炎癥7例以及不明原因3例。單獨FDG PET顯像對FUO的診斷結果中,真暘性27例(52.9%),假暘性14例(27.5%),假陰性9例(17.6%),真陰性1例(2.0%)。相比之下,聯閤PET和CT檢查的PET/CT顯像診斷結果中,真暘性36例(70.6%),假暘性14例(27.5%),假陰性1例(2.0%),真陰性0例(0)。 PET/CT診斷的靈敏度為97.3%(36/37),特異性為0(0/14),準確度為70.6%(36/51)。針對噁性腫瘤,PET或PET/CT的診斷靈敏度及準確度均達100.0%(9/9)。感染與噁性腫瘤病竈的最大標準化攝取值( maximum standardized uptake value ,SUVmax)之間差異有統計學意義(3.7±2.7 vs.7.7±3.5,P=0.001,t=3.6),提示SUVmax可能有助于髮熱病因的鑒彆診斷。結論:FDG PET/CT不但能夠在全身範圍內髮現、定位導緻髮熱的潛在病竈,而且有助于FUO的病因診斷,特彆是對噁性腫瘤的診斷。
목적:평개18 F-FDG PET/CT현상재불명원인발열( fever of unknown origin ,FUO)진단중적림상개치。방법:회고분석2010년8월지2013년4월적51례FUO병례적FDG PET/CT검사결과。의거병이학、실험실검사혹림상수방(대우3개월)득출최종병인진단,통과정성급반정량방법대FDG PET/CT적진단결과진행평개,통계학분석채용조간t검험。결과:51례FUO환자적최종진단포괄감염32례、악성종류9례、비감염성염증7례이급불명원인3례。단독FDG PET현상대FUO적진단결과중,진양성27례(52.9%),가양성14례(27.5%),가음성9례(17.6%),진음성1례(2.0%)。상비지하,연합PET화CT검사적PET/CT현상진단결과중,진양성36례(70.6%),가양성14례(27.5%),가음성1례(2.0%),진음성0례(0)。 PET/CT진단적령민도위97.3%(36/37),특이성위0(0/14),준학도위70.6%(36/51)。침대악성종류,PET혹PET/CT적진단령민도급준학도균체100.0%(9/9)。감염여악성종류병조적최대표준화섭취치( maximum standardized uptake value ,SUVmax)지간차이유통계학의의(3.7±2.7 vs.7.7±3.5,P=0.001,t=3.6),제시SUVmax가능유조우발열병인적감별진단。결론:FDG PET/CT불단능구재전신범위내발현、정위도치발열적잠재병조,이차유조우FUO적병인진단,특별시대악성종류적진단。
Objective: To evaluate the diagnostic value of fluorine-18 fluorodeoxyglucose ( 18 F-FDG) positron emission tomography/computed tomography ( PET/CT) in fever of unknown origin ( FUO) in a Chinese hospital .Methods:The records of 51 patients with FUO (32 men and 19 women;mean age 54 years with a range between 3 and 81 years) were analyzed retrospectively .All the patients were examined by 18 F-FDG PET/CT scan and the results were compared with the final diagnosis which was established by additional procedures including pathology , laboratory examination , and clinical follow-up for more than 3 months.The t test was used for statistical analysis .Results: A final diagnosis was established for 48 patients , including 32 patients with infectious diseases , 9 with malignancies , and 7 with non-infectious inflammatory diseases .By FDG PET scan alone , the rates of true positive , false positive , false negative, and true negative were 52.9%, 27.5%, 17.6%, and 2.0%, respectively.By FDG PET/CT scan, the rates of true positive, false positive, false negative, and true negative were 70.6%, 27.5%, 2.0%, and 0, respectively.18F-PET/CT had a sensitivity of 97.3%(36/37), specificity of 0 (0/14), and accuracy of 70.6%(36/51) in FUO, especially a high sensitivity and accuracy of 100%(9/9) in the diagnosis of malignant tumor .Moreover , the maximum standardized uptake value ( SUVmax ) in tumor was significant higher than that in infection (3.7 ±2.7 vs.7.7 ±3.5, P=0.001, t=3.6), which implied that SUVmax might be useful in differential diagnosis in FUO .Conclusion:FDG PET/CT is a valuable imaging tool for the identification and location of the potential lesion in FUO and is helpful for the etiological diagnosis , especially in the diagnosis of malignant lesions .