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目的探讨使用18氟-脱氧葡萄糖(18FDG)和符合线路计算机断层显像仪(SPECT/PET)的18FDG-PET显像与多层螺旋CT(MSCT)异机图像融合对非小细胞肺癌(NSCLC)淋巴结转移的诊断价值。方法66例确诊为NSCLC患者术前行18FDG-PET显像及胸部64层螺旋CT检查,18FDG-PET图像与64层螺旋CT进行异机图像融合,获得横断面、矢状面、冠状面三维断层图像。利用感兴趣区技术(ROI)的半定量分析计算病变淋巴结(L)与周围纵隔组织(N)的摄取比值R(L/N)。将18FDG-PET检查对肺癌淋巴结转移分期的诊断结果均与术后病理结果进行比较。结果以摄取比值R≥1.5为判断标准,诊断肺癌淋巴结转移的灵敏度为90%(27/30例)、特异度为80.6%(29/36例)、准确率为84.8%(56/66例)、阳性和阴性预测值分别为79.4%(27/34例)和90.6%(29/32例)。27例18FDG-PET显像为阳性的转移淋巴结的分析最大摄取比值为11.5最小为1.7。结论SPECT/PET的18FDG-PET显像对肺癌的纵隔淋巴结转移分期诊断具有较高的灵敏度、特异度和阴性预测值,可为临床确定治疗方案和观察疗效提供重要的临床依据。
Objective To investigate the clinical value of 18FDG-PET and 18FDG-PET imaging and multislice spiral CT (MSCT) inosculation of non-small cell lung cancer (NSCLC) using 18FDG and line computed tomography (SPECT / PET) Diagnostic value of lymph node metastasis. Methods Sixty-six NSCLC patients underwent 18FDG-PET imaging and 64-slice CT chest CT scans, and 18FDG-PET images and 64-slice spiral CT were used to perform the fusion of allograft images. The cross-sectional, sagittal and coronal three-dimensional image. The R (L / N) uptake ratio of diseased lymph nodes (L) to surrounding mediastinal tissue (N) was calculated by semi-quantitative analysis of ROI techniques. The results of 18FDG-PET in diagnosing lymph node metastasis of lung cancer were compared with postoperative pathological results. Results The diagnostic sensitivity was 90% (27/30 cases), specificity was 80.6% (29/36 cases) and the accuracy was 84.8% (56/66 cases) with the ratio of R≥1.5. , The positive and negative predictive value were 79.4% (27/34 cases) and 90.6% (29/32 cases) respectively. 27 cases of 18FDG-PET imaging positive lymph node metastasis analysis of the maximum uptake ratio of 11.5 minimum of 1.7. Conclusion The 18FDG-PET imaging of SPECT / PET has high sensitivity, specificity and negative predictive value for the diagnosis of mediastinal lymph node metastasis in lung cancer, which may provide important clinical evidence for clinical treatment and observation.