~(18)F-FDG PET/CT对不明原因发热病因的诊断价值

目的：探讨^18F-脱氧葡萄糖（FDG）PET/CT显像对不明原因发热（FUO）的影像学表现及病因诊断价值。方法：回顾性分析常规检查未能明确诊断FUO病因的45例患者^18F-FDG PET/CT显像资料,根据病理检查或临床随访结果分析^18F-FDG PET/CT显像结果,测量异常摄取病灶最大标准摄取值（SUVmax）。采用SPSS 11.0软件进行数据处理,SUVmax两样本均数比较采用t检验。结果：45例患者中35例^18F-FDG PET/CT全身显像发现至少有1处异常放射性浓聚灶,随访证实其中9例为恶性肿瘤,26例为感染或炎性病变,二者病变的SUVmax分别为6.09±1.46和2.57±1.33,差异有显著性意义（t=6.67,P〈0.05）;10例^18F-FDG PET/CT显像阴性患者,6例病因不明,4例为风湿性疾病。^18F-FDGPET/CT显像有助于临床FUO病因诊断。结论：全身^18F-FDG PET/CT显像在其它检查方法未能明确诊断FUO病因时,可为临床进一步诊断提供重要的参考价值。

Diagnostic value of 18F-FDG PET/CT in defining the etiology of fever of unknown origin

Objective：To assess the diagnostic value of ^18F-FDG PET/CT in patients with fever of unknown origin（FUO）.Methods：Forty-five patients who were diagnosed as FUO were entered in the study,all those patients underwent ^18F-FDG PET/CT whole body imaging.18F-FDG PET/CT imaging results were analyzed based on either histopathology or clinical follow-up.The maximum standardized uptake values（SUVsmax） were measured.The SUVsmax were analyzed with the t test by SPSS 11.0 software.Results：Among the 45 patients,at least one abnormal accumulation of ^18F-FDG was found in 35 patients,which led to the final diagnosis of malignant tumor in 9 patients,and infection or inflammatory changes in 26 cases.There was a significanct difference in SUVsmax between malignant lesion and benign lesion（6.09±1.46 vs 2.57±1.33）（t=6.67,P〈0.05）.Among ten patients of negative ^18F-FDG PET/CT imaging,4 patients were finally diagnosed as rheumatic diseases,however,the other 6 patients had no final diagnosis.^18F-FDG PET/CT imaging contributed to the clinical diagnosis of the cause of an FUO with an accuracy of 77.8%（35/45）.Conclusions：In patients with an FUO,^18F-FDG PET/CT imaging is valuable to define the etiology of the disease.