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目的:了解发热待查(FUO)的病因构成，并探讨n 18F-脱氧葡萄糖(FDG) PET/CT对FUO中不同类型疾病的鉴别诊断作用。n 方法:回顾性分析2013年1月至2019年8月间在北京大学人民医院行n 18F-FDG PET/CT检查的466例FUO患者[男194例，女272例，年龄3～91(52.7±20.9)岁]的临床及影像资料。根据最终临床诊断分析FUO患者的病因学分布情况，观察不同类别疾病的PET/CT显像表现；以临床问卷方式评估n 18F-FDG PET/CT对FUO的鉴别诊断意义。采用n χ2检验分析组间的构成比差异。n 结果:本组FUO患者中的常见疾病类型依次为风湿免疫病(48.7%，227/466)、感染(28.5%，133/466)和恶性肿瘤(11.2%，52/466)。PET/CT检查中有95.5%(445/466)的患者表现为阳性，其中70.3%(313/445)发现局灶性病变，另29.7%(132/445)仅表现非特异性异常摄取。不同类型疾病中病变易累及部位、形态学改变及FDG摄取情况有所差异。问卷调查结果示，在FUO诊疗过程中PET/CT检查可使95.9%(447/466)的患者获益。与其他类型疾病相比，PET/CT对恶性肿瘤可更多地提示明确诊断(n χ2值：14.408～25.466，均n P<0.001)；对于风湿免疫病，PET/CT帮助或直接提示病因诊断的比例较感染组和不明原因组更高(n χ2值：7.922和9.647，均n P<0.05)。n 结论:18F-FDG PET/CT显像对FUO病因诊断具有较高的临床价值，并可提供多层面诊断信息。n “,”Objective:To further understand the etiological distribution of fever of unknown origin (FUO) in patients underwent n 18F-fluorodeoxyglucose (FDG) PET/CT imaging, and to explore the significance of n 18F-FDG PET/CT in the diagnosis of different types of diseases in FUO patients.n Methods:From January 2013 to August 2019, the clinical and PET/CT image data of 466 FUO patients (194 males, 272 females, age: 3-91(52.7±20.9) years) in Peking University People′s Hospital were retrospectively analyzed. The etiological distribution of FUO patients was analyzed according to the final clinical diagnosis. PET/CT imaging manifestations were analyzed for different types of diseases in FUO patients. The role of n 18F-FDG PET/CT in differential diagnosis for FUO was evaluated through clinical questionnaire. Data were analyzed by using n χ2 test.n Results:The common disease types in FUO patients were rheumatic and immune disease (48.7%, 227/466), infection (28.5%, 133/466) and malignant tumor (11.2%, 52/466). For PET/CT imaging, 95.5% (445/466) of the patients were positive, of which 313 (70.3%, 313/445) were found to have focal lesions, and the other 132 (29.7%, 132/445) showed only nonspecific abnormal uptake. Lesions in different types of diseases were varied in the location, morphological changes as well as FDG uptake. The results of the questionnaire showed that PET/CT imaging could benefit 95.9% (447/466) of the patients in the FUO diagnosis and treatment. PET/CT reached direct etiological diagnosis of malignant tumors more frequently than other types of diseases (n χ2 values: 14.408-25.466, all n P<0.001). PET/CT helped or directly reached the etiological diagnosis of rheumatologic diseases more frequently than infection and unknown cause group(n χ2 values: 7.922, 9.647, both n P<0.05).n Conclusion:18F-FDG PET/CT imaging has high clinical value in the diagnosis of FUO etiology and can provide multilevel diagnostic information.n