刘永，陈鹏，孙振国，袁小帅，陆武开瑞优胜二代
连云港市第一人民医院核医学科，江苏连云港222002
【摘要】目的汽车日常保养常识
探讨不同病理类型的孤立性肺结节(SPN)摄取18F-FDG 的差异，以提高SPN 定性诊断的准确率。方法回顾性分析连云港市第一人民医院2017年9月至2019年8月收治的103例SPN 患者的18F-FDG PET/CT
检查资料，测量病灶标准化摄取值最大值(SUV max )，以病理结果为金标准，分析良恶性结节SUV max 差异，通过秩和检验(Mann-Whitney U 检验)，运用ROC 曲线分析良恶性结节SUV max 的最佳临界值及其诊断效能。结果
103例SPN 患者中恶性病变70例，良性病变33例；70例恶性病变患者的SUV max 为3.95(2.18，8.75)，
其中46例实性结节SUV max 为7.60(3.73，9.66)，24例亚实性结节SUV max 为2.00(1.40，2.73)；33例良性病变患者的SUV max 为1.70(0.75，3.45)，其中6例亚实性病变SUV max 为1.75(0.84，4.73)；恶性病变组患者的SUV max 明显大于良性病变组，差异有统计学意义(P <0.05)，而亚实性病变良恶性的SUV max 比较差异无统计学意义(P >0.05)；剔除亚实性结节，良性与恶性结节患者的SUV max ROC 曲线下面积为0.781，95%可信区间为0.657~0.905，最佳临界值为1.85；若以1.85为良、恶性诊断界值，灵敏度、特异度、准确率、阴性预测值、阳性预测值分别为97.83%、55.56%、82.19%、93.75%、78.95%。结论
不同病理类型孤立性肺结节摄取18F-FDG 有明显差别；实性结节应用1.85标准诊断良恶性准确率较高，小于1.85则高度提示良性，大于1.85则怀疑恶性可能；亚实性结节PET/CT SUV max 参数对其良恶性鉴别价值
mg5三厢相对较小。
suv比较【关键词】孤立性肺结节；肺癌；正电子发射断层扫描；18-氟脱氧葡萄糖；标准化摄取值；受试者工作特性曲线
【中图分类号】R734.2【文献标识码】A 【文章编号】1003—6350（2020）19—2525—04Role of SUV max in the evaluation of solitary pulmonary nodules using 18F-FDG PET/CT.LIU Yong,CHEN P
eng,SUN Zhen-guo,YUAN Xiao-shuai,LU Wu.Department of Nuclear Medicine,First People's Hospital of Lianyungang,Lianyungang 222002,Jiangsu,CHINA
汽车怎么预约试驾【Abstract 】Objective To explore the difference of 18F-FDG uptake in different pathological types of SPN,so
as to improve the accuracy of qualitative diagnosis of SPN.Methods
The data of 103cases of SPN 18F-FDG PET/CT from September 2017to August 2019in First People's Hospital of Lianyungang were analyzed retrospectively.The SUV-max value of lesions was measured.The difference of SUVmax between benign and malignant nodules was analyzed with pathological results as the gold standard.The best critical value and diagnostic efficacy of SUVmax in benign and malignant nodules were discussed by Mann-Whitney U -test and ROC curve analysis of two samples.Results There were 70malignant lesions and 33benign lesions in 103cases of SPN.The SUVmax were 3.95(2.18,8.75)for the 70cases of malignant lesions,7.60(3.73,9.66)for 46cases of solid nodules,2.00(1.40，2.73)for 24cases of sub-solid nodules were.And 1.70(0.75,3.45)were in 33cases of benign lesions,of which 6cases of sub-solid lesions 1.75(0.84,4.73).The difference of SUVmax between malignant group and benign group was statistically significant (P <0.05),but the dif
ference between benign and malignant sub-solid groups was not statistically significant (P >0.05).All sub-solid nodules were excluded,the area under SUVmax ROC curve of benign and malignant nodules was 0.781,the 95%confidence interval was 0.657-0.905,and the optimal critical value was 1.85.The sensitivity,specificity,accuracy,negative predictive value and positive predictive value were 97.83%(45/46),55.56%(15/27),82.19%(60/73),93.75%(15/16),78.95%(45/57),respectively,when 1.85was used as the diagnostic threshold for benign and malignant tumors.Conclusion The uptake of 18F-FDG in solitary pulmonary nodules of different pathological types is significantly differ-ent,and malignant nodules are larger than benign ones.The diagnostic accuracy of solid nodules using the 1.85criterion was higher.Benign nodules were highly suggestive when the diagnostic accuracy was less than 1.85,and malignant nod-ules were suspected when the diagnostic accuracy was greater than 1.85.Subsolid nodule PET has relatively small value in differentiating benign from malignant nodules.
【Key words 】Solitary pulmonary nodules;Lung cancer;Positron emission tomography;18-Fluorodeoxyglucose;Standardized uptake value;Receiver operating characteristic curve
·论著·doi:10.3969/j.issn.1003-6350.2020.19.022
通讯作者：陆武，E-mail：****************
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