标题：18F-FDG SPECT/CT符合显像与CT扫描在淋巴瘤早期疗效评价及预后中的应用价值

      作者：汪建强，曹春晓，杨琦，周凡，廖杰    (西南医科大学附属宜宾二医院核医学科，四川 宜宾 644000)

      卷次： 2016年27卷22期

      【摘要】 目的 探讨氟[18F]-脱氧葡萄糖(18F-FDG)SPECT/CT符合显像与CT扫描在淋巴瘤早期疗效评价及预后中的应用价值。方法 回顾性分析我院2013年12月至2015年10月54例淋巴瘤患者治疗(6~8个疗程)后及随访中均行 18F-FDG SPECT/CT符合显像与CT扫描的结果，根据治疗后早期和6~30个月随访中的 18F-FDG SPECT/CT符合显像结果，与同期CT扫描进行对比，并行疗效临床综合评估，两种检查方法采用χ2检验比较。结果 早期疗效评价中，综合评估结果阳性24例，阴性30例。与综合评估结果比较，18F-FDG SPECT/CT符合显影灵敏度、特异性及准确性分别为 87.5% (21/24)、83.3% (25/30)及 85.2% (46/54)，而CT检查分别为 70.8% (17/24)、63.3% (19/30)及64.8% (35/54)，18F-FDG SPECT/CT符合显影灵敏度、特异性及准确性均高于CT检查，差异均有统计学意义(P<0.05)。长期随访预后评价中，综合评估结果阳性15例，阴性39例。与综合评估结果比较，18F-FDG SPECT/CT符合显影灵敏度、特异性及准确性分别为86.7% (13/15)、84.6% (33/39)及85.2% (46/54)，而CT检查分别为66.7% (10/15)、59.0% (23/39)及61.1% (33/54)，18F-FDG SPECT/CT符合显影灵敏度、特异性及准确性均高于CT检查，差异均有统计学意义(P<0.05)。结论 18F-FDG SPECT/CT符合显像在淋巴瘤早期疗效评价及判断预后有重要临床价值，优于CT检查，且价格适中，可作为常规评估手段。
      【关键词】 淋巴瘤；18F-脱氧葡萄糖；单光子；发射计算体层摄影；预后
      【中图分类号】 R733.4 【文献标识码】 A 【文章编号】 1003—6350（2016）22—3696—04

Application value of 18F-FDG SPECT/CT and CT scan in evaluation of early response to chemotherapy andprognosis of lymphoma.
WANG Jian-qiang, CAO Chun-xiao, YANG Qi, ZHOU Fan, LIAO Jie. Department of NuclearMedicine, the Second People's Hospital of Yibin, the Affiliated Hospital of Southwest Medical University, Yibin 644000,Sichuan, CHINA
【Abstract】 Objective To investigate the application value of 18F-fluorodeoxyglucose single-photon emissioncomputed tomography/computed tomography (18F-FDG SPECT/CT) and CT scan in monitoring early response to treat-ment and prognosis of lymphoma. Methods From December 2013 to October 2015 in our hospital, fifty-four patientswith lymphoma were monitored by 18F-FDG SPECT/CT and CT scan after 6~8 courses of chemotherapy and during thefollow-up of 6~30 months. The results of 18F-FDG SPECT/CT and CT scan were compared to evaluate the early re-sponse to treatment and the prognosis. χ2 test was used for statistical analysis. Results In evaluation of early responseto treatment, clinical synthetic evaluation showed positive in 24 cases and negative in 30 cases. Compared with clinicalsynthetic evaluation, the sensitivity, specificity, accuracy of 18F-FDG SPECT/CT in evaluation of early response to treat-ment were 87.5% (21/24), 83.3% (25/30), 85.2% (46/54), respectively, which were significantly higher than those of CTscan of 70.8% (17/24), 63.3% (19/30) and 64.8% (35/54), P<0.05. In the evaluation of prognosis during clinical fol-low-up, clinical synthetic evaluation showed positive in 15 cases and negative in 39 cases. Compared with clinical synthet-ic evaluation, the sensitivity, specificity, accuracy of 18F-FDG SPECT/CT in evaluation of prognosis were 86.7% (13/15),84.6% (33/39), 85.2% (6/54), respectively, which were significantly higher than those of CT scan of 66.7% (10/15),59.0% (23/39), 61.1%(33/54), P<0.05. Conclusion 18F-FDG SPECT/CT has significant value in monitoring early re-sponse to therapy and predicting prognosis for patients with lymphoma. It is superior to CT scan, at moderate cost, andcan be used as a routine assessment method for lymphoma.
      【Key words】 Lymphoma; 18F-1uomdeoxyglucose; Single-photon; Emission computed tomography (ECT);Prognosis·论 著·doi:10.3969/j.issn.1003-6350.2016.22.029