摘要
目的:评价18F-脱氧葡萄糖(18F-FDG)正电子发射计算机断层摄影(PET-CT)、增强计算机断层摄影(CT)在胰腺癌的诊断、鉴别诊断和分期中的价值。方法:对经病理和临床等综合手段证实的31例胰腺病变患者资料进行回顾分析。分别观察其CT图像中胰腺病变处的形态、密度、强化程度、胰胆管扩张、转移及PET显像胰腺病灶感兴趣区(ROI)最大标准摄取值(SUV max),并结合临床和病理诊断结果,比较单纯PET、增强CT、PET-CT、PET-CT结合增强CT检测对胰腺疾病诊断的灵敏度、特异度及准确率。结果:31例胰腺病变的患者中,胰腺恶性肿瘤20例,良性病变11例。单纯PET对胰腺病变诊断的灵敏度和特异度为85.0%和54.5%,而PET-CT的诊断特异度高于单纯PET,PET-CT诊断的灵敏度、特异度和准确率均高于增强CT[(85.0%、81.8%、83.9%)比(75.0%、72.7%、73.1%)]。PET-CT结合增强CT检查对胰腺病变诊断的灵敏度为100%,特异度为90.9%。增强CT诊断Ⅰ期和Ⅱ期胰腺癌的灵敏度高于PET-CT,但对于Ⅲ期和Ⅳ期胰腺癌患者,PET-CT则可发现更多的淋巴结转移和远处转移。胰腺恶性病变的SUVmax为1.7～18.9,良性病变的SUVmax为0.6～5.0,良恶性病变间平均SUVmax差异有统计学意义(P<0.05)。结论:PET-CT检查将功能学与解剖形态学显像相结合,在胰腺肿瘤的诊断与分期中的作用优于单纯PET或CT检查。对于胰腺癌的T分期,增强CT优于PET-CT,而PET-CT在显示淋巴结和远处转移方面优于增强CT,两者各有优缺点。在胰腺癌的诊断和分期中,PET-CT检查结合增强CT能提高诊断的灵敏度、特异度及准确率。
Objective To assess values of ^18F- fluorodeoxy-glucose positron emission tomography-computed tomography （PET-CT）, and enhanced CT in the diagnosis, differential diagnosis and staging of pancreatic cancer. Methods Thirty-one patients with pathologically and/or clinical comprehensively diagnosed pancreatic diseases were analyzed retrospectively. The pancreatic lesion morphology, density, degree of enhancement, dilation of pancreatic- biliary duct and metastasis on enhanced CT and the pancreatic lesion region of interest （ROI） and maximum standardized uptake value （SUVmax） on PET imaging were observed. The sensitivity, specificity and accuracy rate of enhanced CT, PET-CT and PET combined with enhanced CT were compared. Of the 31 cases, 20 were malignant tumor and 11 were benign lesion. Results The sensitivity and specificity of PET in diagnosing pancreatic disease were 85.0% and 54.5%, respectively. The sensitivity, specificity and accuracy rate of PET-CT were higher than that of enhanced CT [（85.0%, 81.8% and 83.9%） vs （75.0%, 72.7% and 73.1%）]. The sensitivity and specificity of PET-CT combined with enhanced CT in diagnosing pancreatic diseases were 100.0%. The sensitivity of enhanced CT in diagnosing stage I and stage Ⅱ pancreatic cancer was higher than that of PET-CT, whereas PET-CT could detect more lymph node metastasis and distant metastasis in patients with stage Ⅲ and stage Ⅳ pancreatic cancer. The SUVmax of pancreatic malignant lesion was 1.7 to 18.9 and that of benign lesion was 0.6 to 5.0, the difference of average SUVmax between malignant and benign lesions was statistically significant （P〈0.05）. Conclusions PET-CT combined the functional and anatomic-morphological imaging is superior to sole PET or CT in the diagnosis and differential diagnosis of pancreatic tumor. Enhanced CT is superior to PET-CT in staging assessment of pancreatic cancer, whereas PET-CT is superior to enhanced CT in detecting lymph node metastasis and distant metastasis. PET-CT combined enhanced CT c
出处
《诊断学理论与实践》
2009年第1期50-54,共5页
Journal of Diagnostics Concepts & Practice
基金
上海市教委重点学科建设基金资助(S30203)
关键词
肿瘤
胰腺
正电子发射计算机断层摄影
增强计算机断层摄影
诊断
Neoplasms, pancreas
Positron emission tomography-computed tomography
Enhanced computer tomography
Diagnosis
