摘要
目的探讨^18F—FDGPET／CT显像在肝门胆管癌术前评估中的作用。方法回顾性分析32例肝门胆管癌患者资料（男18例，女14例，平均年龄56岁），均经手术和病理或临床等综合手段证实，术前均行PET／CT显像，观察肝门部胆管癌患者的PET／CT表现，并与手术及病理对照分析。结果32例肝门部胆管癌患者中，按照Bismuth—Corlette分型，Ⅰ型、Ⅱ型、Ⅲa型、mb型和Ⅳ型分别为3、2、4、8和15例。16例行根治性切除术，其中Ⅰ型、Ⅱ型、Ⅲa型、Ⅲb型和Ⅳ型分别为3、2、1、7和3例，7例行姑息性手术，9例仅行剖腹探查术。PET／CT判断原发肿瘤部位及Bismuth—Corlette分型的准确率达81．2％（26／32）。PET／CT检测肝门部胆管癌淋巴结转移的敏感度、特异度和准确度分别为64．7％、86．7％及75．0％，检测肝门部胆管癌远处转移方面的敏感度、特异度和准确度分别为41．7％、95．0％及75．0％。PET／CT术前可切除性评价与术中评价一致率为75．0％（24／32），其对肝门胆管癌术前可切除性评价与术中评价结果对照差异无统计学意义（X^2=0．125，P〉0．05）。结论PET／CT显像在诊断肝门胆管癌及检测淋巴结转移和远处转移方面具有重要价值，可作为肿瘤术前可切除性判断的重要依据。
Objective To evaluate the value of positron emission tomography/computed tomography （PET/CT） in the preoperative assessment of hilar cholangiocarcinoma （ HC ）. Methods A retrospective analysis was performed for 32 HC patients. There were 14 females and 18 males with a mean age of 56 years old. All cases were confirmed by surgery, pathology or other diagnostic modalities, is F-fluorodeoxyglueose （FDG） PET/CT was performed preoperatively in all patients. The images were interpreted and compared with the operative and pathological outcomes in each case. Results Among them, according to the Bismuth- Corlette classification, the number of types Ⅰ , Ⅱ , Ⅲ a, Ⅲb and Ⅳ patients, were 3, 2, 4, 8 and 15 respectively. Radical tumor resection was performed in 16 patients. Among them, 3, 2, 1, 7 and 3 patient belonged to types Ⅰ ,Ⅱ , Ⅲ a, Ⅲb and Ⅳ respectively. Seven patients underwent palliative surgery and 9 had only surgical exploration. The detecting accuracy of PET/CT in primary tumors Bismuth-Corlette classification reached 81.25% （26/32）. The sensitivity, specificity and accuracy of PET/CT in detecting lymph node metastasis and distant metastasis were 64.7% , 86. 7% , 75.0% and 41.7% , 95.0% , 75.0% respectively. The concordance rate of preoperative evaluation of respectability by PET/CT and intraoperative evaluation was 75.0%. No significant difference existed between PET/CT and the surgical and histopathologic findings in the evaluation of curative resectability for HC （ X2 = 0. 125, P 〉 0. 05）. Conclusion is F-FDG PET/CT is of great value in the diagnosis of HC, as well as Ⅱa detecting lymph node metastasis and distant metastasis. Thus ^18F-FDG PET/CT is helpful in the preoperative assessment of resectability for HC.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2012年第20期1409-1412,共4页
National Medical Journal of China
关键词
胆管肿瘤
正电子发射断层显像术
诊断
肿瘤转移
可切除性
Hilar eholangiocareinoma
Positron-emission tomography
Diagnosis
Neoplasms metastasis
Resectability
