摘要
目的:探讨18F-FDGPET、CT和血管造影对原发性肝癌TACE后残留及转移病灶的检出能力。材料与方法:80例经穿刺活检或手术病理证实的肝癌患者,其中高分化肝细胞癌20例、中分化肝细胞癌44例、低分化肝细胞癌11例、肝胆管细胞癌3例、肝腺癌2例。以临床随访6个月以上及部分病理结果为标准,回顾性分析TACE后1.5～2个月18F-FDGPET、CT和血管造影对肿瘤残留及转移病灶的显示情况。结果:80例患者肝内共104个病灶,经临床随访6个月以上及部分病理结果证实,有肿瘤残留病灶62个,PET正确检出56个,CT正确检出38个,血管造影正确检出58个;无肿瘤残留病灶42个,PET正确检出40个,CT正确检出40个,血管造影正确检出42个。PET和血管造影对肝癌TACE后肿瘤残留病灶检出的灵敏度和准确性分别为90.3%、92.3%和93.6%、96.2%,明显高于CT(61.3%、75.0%),差异显著(P<0.01)。同时PET检出了CT和血管造影无法发现的肝外转移病灶5例。结论:CT是肝癌TACE后最常用的随访方法,可以清晰显示碘油在病灶内的分布情况。18F-FDGPET显像能够更加准确的鉴别肿瘤存活,特别是CT无法明确的病变,而且对于肝外转移病灶的检出具有独特的优势。血管造影的诊断灵敏度、准确性最高,但是属于有创性检查。将多种影像学方法相结合,能够为临床提供更加可靠的定位和定?
Objective: To evaluate the value of 18F-fluorodeoxyglucose(FDG) PET imaging, CT and angiography for detecting residual and metastatic lesions of primary liver carcinoma after transcatheter arterial chemoembolization(TACE). Materials and Methods: Twenty cases of well-differentiated hepatocellular carcinoma(HCC), 44 cases of moderately differentiated HCC, 11 cases of poorly-differentiated HCC, 3 cases of hepatocholangiocarcinoma and 2 cases of hepatoadenocarcinoma in 80 patients were proved by biopsy or histologic examination. A retrospective analysis of detecting residual and metastatic lesions with PET, CT and angiography was performed after TACE during 1.5～2 months. PET, CT and angiography findings were compared on the basis of clinical follow-up and histologic examination. Results: One hundred and four lesions were found in 80 patients. Sixty-two lesions with and the other 42 lesions without residual viable tumor were confirmed by the clinical follow-up and histologic examination. Fifty-six lesions with and 40 without residual viable tumor were found on PET, and PET displayed 90.3% sensitivity, 92.3% accuracy. Thirty-eight lesions with and 40 lesions without residual viable tumor were found on CT, and its sensitivity and accuracy were 61.3% and 75.0%. Fifty-eight lesions with and 42 without residual viable tumor were found on angiography, and angiography displayed 93.6% sensitivity, 96.2% accuracy. The sensitivity and accuracy between PET, angiography and CT in evaluating the residual viable tumor of HCC after TACE were significantly different(P<0.01). Five cases with extrahepatic metastasis were found by PET, which were not detected through CT and angiography. Conclusion: CT is the commonest imaging modality in the follow-up of primary liver carcinoma, which can demonstrate the patterns of lipiodol deposited within lesions. 18F-FDG PET imaging can detect activity of tumor, especially in those residual viable lesions that can not be detected by CT. PET has advantage of detecting extrahepatic metastasis also.
出处
《中国临床医学影像杂志》
CAS
2004年第9期509-512,529,共5页
Journal of China Clinic Medical Imaging
