目的 系统评价PET/CT与HRCT 相结合诊断孤立性肺结节 ( s o l i t a r y pulmonary nodule，SPN)的临床价值。 方法 计算机检索PubMed、EMBASE、 Cochrane Library、Web of Science、 维普、万方、CBM和CNKI等中英文数据 库，检索并筛选出有关PET/CT与HRCT 相结合诊断SPN的研究。提取数据，采 用Meta-DiSc 1.4及RevMan 5.0软件对 所提取数据进行统计分析。结果 最终 纳入8篇文献,包括538个结节。Meta 分析结果显示：与金标准相比，PET/ CT、HRCT、PET/CT结合HRCT诊断SPN 的敏感度分别为PET/CT 0.91(0.86- 0.94)、HRCT 0.88(0.80-0.93)、PET/ CT结合HRCT 0.96(0.93-0.98)；特异 度分别为：PET/CT 0.65(0.59-0.70)、 HRCT 0.85(0.76-0.92)、PET/CT结合 HRCT 0.93(0.89-0.96)；诊断比值比分别 为：PET/CT 23.08(13.48-39.52)、HRCT 45.86 (19.42-108.29)、PET/CT结合HRCT 306.49(125.93-745.94)；SROC曲线下的 面积分别为0.8967，0.9351，0.9844。结 论 PET/CT结合HRCT综合分析提高了诊断 SPN的敏感性、特异性及准确性，其诊断 效能明显优于单独使用PET/CT或HRCT，在 SPN的良恶性鉴别方面更具优势，为临床 诊断提供帮助，从而避免不必要的手术。

Objective The study aims for an overall evaluation of the clinical value of differential diagnosis of solitary pulmonary nodule (SPN) with PET/CT integrated high resolution CT(HRCT) by using a meta-analysis. Methods Such databases as PubMed, EMBASE, Cochrane Library, Web of Science, VIP, Wanfang, CBM and CNKI were searched and screened for articles about using PET/CT and HRCT to diagnose SPN. The Metadisc1.4 and RevMan 5.0 software were used to analyze the data. Results A total of 8 articles were included finally, involving 538 nodules. The meta-analysis showed that, compared with reference standard, the summary sensitivity, specificity, diagnostic odds ratio and area under SROC curve for PET/CT, HRCT, PET/CT integrated HRCT diagnosing SPN were 0.91(0.86-0.94), 0.65(0.59-0.70), 23.08(13.48-39.52) and 0.8967; 0.88(0.80-0.93), 0.85(0.76-0.92), 45.86 (19.42-108.29) and 0.9351, 0.96(0.93- 0.98), 0.93(0.89-0.96), 306.49(125.93-745.94), 0.9844), respectively. Conclusion The comprehensive analysis by combining PET/CT and HRCT can greatly improve the sensitivity, specificity and accuracy in the diagnosis of SPN, and has superior diagnosis efficiency than use PET/CT or HRCT alone, and has more advantage in differentiation of benign and malignant SPN, so as to avoid unnecessary surgery.