摘要
目的探讨18F-双脱氧葡萄糖(FDG)PET/CT全身显像诊断小肠结核的价值。方法回顾10例小肠结核和25例小肠恶性肿瘤的18F-FDG PET/CT显像资料,结果经组织学、诊断性治疗和(或)临床随访证实;测量病灶的最大标准摄取值(SUVmax)及肠壁厚度,总结鉴别诊断小肠结核的方法。结果 (1)小肠结核PET/CT主要表现为小肠条状高代谢灶(70%)、病灶呈"跳跃性"分布(90%)、局部肠壁增厚(70%)、灶周淋巴结肿大(70%)等征象,小肠恶性肿瘤这些征象的发生率分别为20%(P<0.01)、8%(P<0.01)、84%(P>0.05)、72%(P>0.05)。(2)小肠结核灶的SUVmax为8.61±2.99、病灶肠壁厚度为10.00±3.02mm、灶周肿大淋巴结的SUVmax为5.63±3.36,小肠恶性肿瘤分别为9.65±5.48(P>0.05)、14.20±2.00mm(P<0.01)、7.00±5.61(P>0.05)。(3)结核杆菌累及回肠10例(100%)、空肠7例(70%)、回盲部3例(30%)、结肠2例(20%);脾脏浸润2例、肝脏1例。8例(80%)有腹腔外结核灶,其中肺部7例、咽部1例、腰骶椎1例。(4)综合考虑临床表现、病史及PET/CT影像特点,PET/CT显像诊断小肠结核的正确率为90%。结论小肠结核的18F-FDG PET/CT的主要影像特征为小肠条状高代谢灶、病灶呈"跳跃性"分布、局部肠壁一定程度增厚及腹腔外结核灶,具有较高的临床鉴别诊断价值,SUVmax及肠系膜淋巴结肿大并代谢增高不能作为鉴别诊断的指标。
Objective To investigate the diagnostic value of 18F - fluorodeoxyglucose （FDG） PET/CT whole body imaging in patients with small intestine tuberculosis（ SIT）. Methods A retrospective study was carried out on ISF - FDG PET/CT datas of 10 patients with SIT and 25 patients with small intestine carcinoma（SIC）. All results were proved by pathological, or diagnostic therapy and/or clini- cal follow -up. The intestinal wall thickness（IWT） and maximum standardized uptake value（SUVmax） were used to analyze the images. The distinguish diagnostic methods to SIT was summarized. Results （2）The 18F - FDG PET/CT imaging signs showed that the lesions of SIT were intestinal high radioactive concentration focus（70% ） , ＂jump＂ distribution of the lesion （90%） , local wall thickening （70%） and the perifocal lymph nodes enlargement（70% ）. The signs of SIC were 20.00% （ P 〈 O. O1 ） , 8.00% （ P 〈0. 01 ） , 84% （ P 〉 0.05 ） and 72.00% （ P 〉 0.05 ） , respectively. （~）The SUVmax of SIT was 8.61 ＋ 2.99, the IWT was 10. O0 ＋ 3.02mm. The SUVmax of the peri- focal lymph nodes enlargement was 5.63 ＋ 3.36. The SIC was 9.65 ＋ 5.48 （ P 〉0. 05 ） , 14. 20 ＋ 2.00mm （ P 〈 0. O1 ） and 7.00 ~ 5.61 （ P 〉 0.05） , respectively. （~）The ileum was involved by mycobacterium tuberculosis in 10 cases（ 100% ） , jejunum in 7 cases（70% ） , cecum and terminal ileum together in 3 cases （30%） , and colon in 2 cases（20% ）. The spleen was infiltrated by mycobacterium tuberculosis in 2 cases, liver in 1 cases. The extra abdominal tuberculosis focus were found in 8 cases（80% ）. Among them, the lung tuberculosis le- sions were found in 7 cases, pharyngeal in 1 cases, lumbosacral spine in 1 cases. （~）Considering the clinical manifestations, history and PET/CT imaging features comprehensively, the correct rate in the diagnosis of SIT was 90%. Conclusion The main imaging features of 18F -FDG PET/CT imaging are intestinal high radioactive concentrati
出处
《医学研究杂志》
2013年第11期140-143,共4页
Journal of Medical Research
