18F-FDG PET/CT在不明原因发热诊断中的价值

Value of 18F-FDG PET/CT for diagnosis of fever of unknown origin

  • 摘要: 目的 评价18氟脱氧葡萄糖正电子发射断层显像/计算机体层扫描(18 fluorine-fluoro-2-deoxy-D-glucose,positronemission tomography/computer tomography,18F-FDG PET/CT)在不明原因发热(fever of unknown origin,FUO)诊断中的价值。 方法 回顾性分析本院发热疾病科2012年1-12月间行18F-FDG PET/CT检查的FUO患者临床资料,将18F-FDG PET/CT影像学诊断和最后临床诊断进行比较。 结果 本研究共纳入FUO患者78例,其中感染性疾病21例(26.9%)、结缔组织病9例(11.5%)、恶性肿瘤24例(30.8%)、杂病类9例(11.5%),最终仍有15例(19.3%)未能明确诊断。18F-FDG PET/CT在所有FUO病例诊断准确率75.6%,敏感度100%,特异度44.1%,阳性预测值69.8%,阴性预测值100%,在恶性肿瘤准确率、敏感度和阳性预测值均为100%。 结论 18F-FDG PET/CT在FUO诊断中具有非常高的敏感度和阴性预测值,在恶性肿瘤诊断中帮助很大,值得推广。

     

    Abstract: Objective To assess the value of 18F-FDG PET/CT for the diagnosis of fever of unknown origin(FUO). Methods The clinical data about FUO patients who underwent 18F-FDG PET/CT in Department of Fever-Related Diseases, Chinese PLA General Hospital, from January 2012 to December 2012, were retrospectively analyzed. Their 18F-FDG PET/CT diagnosis and final clinical diagnosis were compared. Results Of the 78 FUO patients included in this study, 21(26.9%) were diagnosed with infectious diseases, 9(11.5%) were diagnosed with connective tissue diseases, 24(30.8%) were diagnosed with malignant tumor, 9(11.5%) were diagnosed with miscellaneous diseases, and 15(19.3%) were not clearly diagnosed. The accuracy, sensitivity, specificity, positive and negative predicting value of 18F-FDG PET/CT were 75.6%, 100%, 44.1%, 69.8% and 100%, respectively, for the diagnosis of FUO. Conclusion The sensitivity and negative predicting value of 18F-FDG PET/CT are very high for the diagnosis of FUO and should thus be popularized in the diagnosis of malignant tumors.

     

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