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目的:探讨PET/CT与胸部诊断CT在乳腺癌术后随访中的应用价值。方法:70例乳腺癌术后患者,共进行18F-脱氧葡萄糖(FDG)PET/CT检查81人次;同日行胸部诊断CT扫描。以活检或手术后病理或随访结果作为参考标准,比较PET/CT与胸部诊断CT图像。结果:其中31人次PET/CT及对应的胸部诊断CT图像均未见病灶。另外50人次共检出372个病灶。PET/CT的总体灵敏度、特异性、准确性、阳性预测值、阴性预测值分别为88.0%、50.0%、84.9%、95.3%、26.8%;而胸部诊断CT检查分别为60.5%、31.6%、57.5%、88.6%、8.3%。对淋巴结转移,PET/CT的灵敏度(100%)高于胸部诊断CT的灵敏度(52.3%)。对骨骼及胸壁软组织转移,PET/CT的灵敏度(98.1%)也高于胸部诊断CT的灵敏度(25.0%)。但是,PET/CT对肺转移灶检测的灵敏度(58.8%)低于胸部诊断CT(98.9%)。结论:对乳腺癌术后淋巴结、骨骼与软组织转移的检测PET/CT优于胸部CT。但PET/CT一次成像技术并不能取代胸部CT,对于怀疑肺部小结节转移的患者,胸部诊断CT扫描是必要的、有益的。
Objective: To investigate the value of PET / CT and chest CT in postoperative follow-up of breast cancer. Methods: 70 cases of breast cancer patients, a total of 18F- deoxyglucose (FDG) PET / CT examination 81 passengers; diagnostic chest CT scans on the same day. With biopsy or postoperative pathology or follow-up results as a reference standard, PET / CT and chest CT images were compared. Results: There were no lesions in 31 PET / CT and corresponding chest CT images. Another 50 people were detected 372 lesions. The overall sensitivity, specificity, accuracy, positive predictive value and negative predictive value of PET / CT were 88.0%, 50.0%, 84.9%, 95.3% and 26.8% respectively, while those of chest CT were 60.5%, 31.6% 57.5%, 88.6%, 8.3%. For lymph node metastases, the sensitivity of PET / CT (100%) is higher than that of chest CT (52.3%). For skeletal and chest wall soft tissue metastases, the sensitivity of PET / CT (98.1%) was also higher than that of chest CT (25.0%). However, the sensitivity of PET / CT to lung metastases (58.8%) was lower than that of chest CT (98.9%). Conclusion: The detection of postoperative lymph node, bone and soft tissue metastases in breast cancer is better than chest CT in detecting PET / CT. But PET / CT imaging technology can not replace the chest CT, in patients with suspected pulmonary nodule metastasis, chest CT scan diagnosis is necessary and beneficial.