摘要
目的评价18F-脱氧葡萄糖(18F-FDG)PET/CT显像在泌尿系各肿瘤中的诊断的应用。方法回顾性分析56例泌尿系肿瘤患者,男47例,女9例,年龄40～88岁,其中肾癌28例,膀胱癌14例,肾盂癌2例,前列腺癌3例,肾错构瘤5例,精原细胞瘤2例。所有患者均行18F-FDGPET/CT显像,并进行PET/CT融合图像、PET图像和CT图像帧对帧对比分析。结果 2例患者双侧肾上腺占位,PET示高代谢,1例明确诊断为弥漫性大B细胞淋巴瘤,1例为肾上腺结核;12例肾癌术前患者CT均能发现,PET提示9例为高代谢,3例阴性;16例肾癌术后10例高代谢中6例发现转移灶;5例膀胱癌PET表现为高代谢,9例术后复查8例高代谢中6例发现转移;3例前列腺癌患者中仅1例表现为高代谢,1例前列腺癌合并骨转移患者治疗2年后,PET未能发现骨转移。1例左侧后腹膜原发性精原细胞瘤PET检查,后腹膜区可见多个结节状略高代谢病灶。1例肾盂癌患者PET示左侧肾盂内团块状高代谢病灶,SUV值15.4。总体敏感度85.7%,特异度66.7%。结论 18F-FDGPET/CT因经泌尿系代谢,对肾、膀胱癌、前列腺的原发病灶显影效果欠佳,对于术后复查患者转移灶的早期发现和定位有价值。
Objective To investigate the role of 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging in the detection of urologic tumor.Methods 56 patients with urologic tumor underwent 18F-FDG PET/CT,PET/CT confluens imaging,PET image and CT picture.There were 47 male and 9 female patients with ages from 40 to 88 years old.There were 28 patients with renal carcinoma,14 with bladder carcinoma,2 with renal pelvic carcinoma,3 with prostatic carcinoma,5 with angiomyolipoma of kidney,2 with spermatocytoma.Results 2 adrenal hypermetabolic lesion were showed by PET,1 was diagnosed as diffuse large B cell lymphoma,the other was adrenal tuberculosis.All the 12 kidney carcinoma before operation could be found by CT,9 in them were hypermetabolic by PET,and the other 3 were negative.Among all the 16 patients after kidney carcinoma operation,metastasis lesions were found in 6 of 10 hypermetabolism.hypermetabolic lesion was found in 5 bladder carcinoma.Among all the 9 bladder carcinoma re-examination patients,metastasis lesions were found in 6 of 8 hypermetabolism.1 hypermetabolic lesion was found among 3 cases of prostate carcinoma.Osseous metastasis wasnot found in 1 case of prostate carcinoma complicated with osseous metastasis after 2 years medical treatment.Several hypermetabolism nodosity were found in post-peritoneotome in the patient with primary spermatocytoma in left post-peritoneotome.Hypermetabolic conglomeration was found in the patient with renal pelvic carcinoma,which SUV is 15.4.Overall sensitivity is 85.7%,specificity is 66.7%.Conclusions Metastasis lesions after operation could be discovered and detected by 18F-FDG PET/CT while the imaging of primary lesion of kidney,bladder and prostate is not as satisfactory as expected for the metabolism of urologic system.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第7期1951-1956,共6页
Chinese Journal of Clinicians(Electronic Edition)
