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[目的]利用ROC曲线分析评价PET/CT双时相显像对孤立性肺结节(SPN)的诊断价值。[方法]回顾性分析病理确诊或随访确诊的SPN行PET/CT双时相检查的142例患者。所有患者注射显像剂后60min行PET/CT早期显像,120min后行延迟显像。以半定量方法测定结节早期及延迟期SUVmax值,并计算代谢滞留指数(RI)。以RI≥10%为阳性判断标准对结节进行定性诊断,计算其诊断的灵敏度、特异性、准确率、阳性预测值及阴性预测值。绘制相应ROC曲线并计算曲线下面积,以分析PET/CT双时相显像诊断SPN的效能。[结果]良性结节延迟期SUVmax值与早期比较差异无统计学意义(P>0.05);而恶性结节延迟期SUVmax值较早期显著增高(P<0.05)。以RI≥10%为阳性,<10%为阴性,其诊断SPN的灵敏度、特异性、准确率、阳性预测值、阴性预测值分别为83.5%、51.3%、74.6%、81.9%、54.1%。PET/CT双时相显像诊断SPN的ROC曲线下面积为0.707±0.053,以约登指数最大值为界点,确立ROC曲线的最佳截断值为5%,对应诊断SPN的灵敏度、特异性和准确率分别为92.2%、48.7%和80.3%。[结论]PET/CT双时相显像鉴别SPN良恶性有一定的临床价值,对于早期显像诊断困难的SPN,建议双时相PET/CT检查有助于鉴别。
[Objective] To evaluate the diagnostic value of double-phase PET / CT in the diagnosis of solitary pulmonary nodules (SPN) by ROC curve analysis. [Methods] A total of 142 patients undergoing SPN PET / CT double-phase examinations confirmed by pathology or follow-up were retrospectively analyzed. All patients underwent PET / CT imaging at 60min after injection of imaging agent and delayed imaging at 120min. The SUVmax values of early and late nodules were determined by semi-quantitative method and the metabolic retention index (RI) was calculated. The nodules were qualitatively diagnosed with RI≥10% as the positive criterion, and the diagnostic sensitivity, specificity, accuracy, positive predictive value and negative predictive value were calculated. Draw the corresponding ROC curve and calculate the area under the curve to analyze the performance of PET / CT bi-phase imaging diagnosis of SPN. [Results] There was no significant difference in the SUVmax value between the delayed nodules and the early nodules (P> 0.05), while the SUVmax values in the delayed nodules were significantly higher than those in the early nodules (P <0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of SPN were 83.5%, 51.3%, 74.6%, 81.9% and 54.1% respectively, with RI≥10% as positive and <10% as negative. The area under the ROC curve of PET / CT dual-phase imaging in diagnosis of SPN was 0.707 ± 0.053, and the best cutoff value of ROC curve was established with the maximum of Youden index as the cutoff point, which corresponded to the sensitivity and specificity of diagnosing SPN And the accuracy rates were 92.2%, 48.7% and 80.3% respectively. [Conclusion] PET / CT dual-phase imaging has some clinical value in differentiating benign and malignant SPN. It is suggested that dual-phase PET / CT can be helpful for the early diagnosis of SPN.