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18F-FDG PET/CT、超声造影及联合应用对胰腺良恶性病变的鉴别诊断价值比较

郑立春 张晓明 余天颖 李洁 邓小倩 欧阳向柳

引用本文:
Citation:

18F-FDG PET/CT、超声造影及联合应用对胰腺良恶性病变的鉴别诊断价值比较

DOI: 10.3969/j.issn.1001-5256.2022.12.017
基金项目: 

唐山市科学技术研究与发展计划 19150220E

伦理学声明:本研究方案于2019年6月24日经由唐山市工人医院伦理委员会审批,批号: GRYY-LL-2019-39。患者均签署知情同意书。
利益冲突声明:本研究不存在研究者、伦理委员会成员、受试者监护人以及与公开研究成果有关的利益冲突。
作者贡献声明:郑立春、余天颖对研究的思路或设计有关键贡献;李洁、邓小倩参与了研究数据的获取分析解释过程;张晓明、欧阳向柳参与起草和修改了文章关键内容。
详细信息
    通信作者:

    欧阳向柳,usouyangxl@163.com

Value of 18F-FDG PET/CT, contrast-enhanced ultrasound, and their combined use in differential diagnosis of benign and malignant pancreatic lesions: A comparative study

Research funding: 

Science & Technology Program of Tangshan 19150220E

More Information
  • 摘要:   目的  探讨18F-FDG PET/CT、超声造影及联合应用对胰腺病变良恶性鉴别的诊断价值。  方法  回顾性分析2015年1月—2020年12月于唐山市工人医院行18F-FDG PET/CT和超声造影检查的胰腺病变患者资料,以病理结果为标准,分析18F-FDG P ET/CT、超声造影及两者联合时对胰腺病变良恶性鉴别诊断的灵敏度、特异度、准确度、阳性预测值及阴性预测值。计量资料组间比较采用t检验;计数资料组间比较采用χ2检验。  结果  108例病变中恶性83例、良性25例,18F-FDG PET/CT诊断灵敏度、特异度、准确度、阳性预测值及阴性预测值分别为86.75%、80.00%、85.19%、93.51%及64.52%,超声造影分别为69.88%、76.00%、71.30%、90.63%及43.18%,两者联合应用时分别为90.36%、84.00%、88.89%、94.94%及72.41%。18F-FDG PET/CT与超声造影两者间灵敏度、准确度比较差异均有统计学意义(P值均<0.05)。  结论  18F-FDG PET/CT对胰腺病变良恶性鉴别具有较高的诊断价值,高于超声造影,两者联合应用时可进一步提高诊断价值。

     

  • 图  1  PDAC18F-FDG PET/CT图像

    注:患者,男,58岁,胰头导管腺癌,18F-FDG PET/CT显示18F-FDG明显不均匀性增高,SUVmax为5.4(箭头)。a,PET;b,CT;c,PET/CT;d,PET MIP。

    Figure  1.  18F-FDG PET/CT imaging of pancreatic ductal adenocarcinoma

    图  2  AIP18F-FDG PET/CT图像

    注:患者,男,36岁,AIP,18F-FDG PET/CT显示胰腺整体弥漫性肿大,18F-FDG摄取呈弥漫性增高,呈“腊肠样”表现,SUVmax为6.1 (箭头)。a,PET;b,CT;c,PET/CT;d,PET MIP。

    Figure  2.  18F-FDG PET/CT imaging of autoimmune pancreatitis

    图  3  PDAC超声造影动脉期图像

    注:患者,男,58岁,胰头导管腺癌(与图 1同一患者),超声造影显示胰头病变动脉期呈低增强(箭头)。a,常规超声;b,超声造影动脉期。

    Figure  3.  Contrast-enhanced ultrasound imaging of pancreatic ductal adenocarcinoma in arterial phase

    图  4  PDAC超声造影静脉期图像

    注:患者,男,58岁,胰头导管腺癌(与图 1同一患者),超声造影显示胰头病变静脉期呈低增强(箭头)。a,常规超声;b,超声造影静脉期。

    Figure  4.  Contrast-enhanced ultrasound imaging of pancreatic ductal adenocarcinoma in venous phase

    图  5  AIP超声造影动脉期图像

    注:患者,男,36岁,AIP(与图 2同一患者),超声显示胰腺整体弥漫性肿大,动脉期造影呈均匀性等增强表现(箭头)。a,常规超声;b,超声造影动脉期。

    Figure  5.  Contrast-enhanced ultrasound imaging of autoimmune pancreatitis in arterial phase

    图  6  AIP超声造影静脉期图像

    注:患者,男,36岁,AIP(与图 2同一患者),超声显示胰腺整体弥漫性肿大,静脉期造影呈均匀性等增强表现(箭头)。a,常规超声;b,超声造影静脉期。

    Figure  6.  Contrast-enhanced ultrasound imaging of autoimmune pancreatitis in venous phase

    表  1  3种诊断方法分别对胰腺良恶性病变检出的数目比较

    Table  1.   Comparison of 3 diagnostic results with the number of benign and malignant pancreatic lesions

    病理 例数 PET/CT(例) 超声造影(例) PET/CT+超声造影(例)
    + + +
    恶性 83 72 11 58 25 75 8
    良性 25 5 20 6 19 4 21
    下载: 导出CSV

    表  2  3种诊断方法对胰腺良恶性病变诊断指标比较

    Table  2.   Comparison of 3 diagnostic indexes of benign and malignant pancreatic lesions

    组别 灵敏度 特异度 准确度 阳性预测值 阴性预测值
    PET/CT 86.75%1) 80.00% 85.19%1) 93.51% 64.52%
    超声造影 69.88% 76.00% 71.30% 90.63% 43.18%
    PET/CT+超声造影 90.36%1) 84.00% 88.89%1) 94.94% 72.41%
    χ2 6.952 0.117 6.119 0.403 3.316
    P 0.008 0.733 0.013 0.546 0.069
    注:与超声造影比,1)P<0.05。
    下载: 导出CSV
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