PET/CT及其他影像手段对胰腺癌诊断的比较研究  

The comparative study of diagnostic value of PET/CT and other imaging methods on pancreatic carcinoma

作　　者：王中秋[1] 卢光明[1] 郑玲[1] 朱虹[2] 常林风[2] 吴江[2] 秦莉萍[2] 

机构地区：[1]南京军区南京总医院医学影像科,江苏南京210002 [2]南京军区南京总医院核医学科,江苏南京210002

出　　处：《医学影像学杂志》2006年第1期84-87,共4页Journal of Medical Imaging

摘　　要：目的:探讨18F-脱氧葡萄糖(FDG)PET/CT显像、增强CT和综合手段对胰腺癌的诊断和鉴别诊断价值。方法:对经病理和临床等综合手段证实的32例胰腺病变的患者进行回顾性分析。分别观察胰腺病变的CT形态、密度、强化程度、胰胆管扩张、转移以及PET显像胰腺病灶感兴趣区(ROI)标准摄取最大值(SUVmax)。结合临床和病理诊断结果,分别比较分析单纯PET、单纯CT平扫、增强CT、PET/CT和综合手段对胰腺疾患诊断的敏感性、特异性、准确性。结果:32例胰腺病变中,胰腺恶性肿瘤26例,其中20例为胰腺癌,3例为胰腺癌手术后复发,2例为胰腺转移癌,1例为交界性肿瘤(潜在恶性);良性病变为6例,其中5例为肿块性慢性胰腺炎,1例为急性胰腺炎。胰腺周围和腹膜后淋巴结转移8例,腹膜及肠系膜转移4例,肝脏转移7例,骨转移2例,其他部位转移2例。单纯PET、单纯CT、增强CT、PET/CT和综合手段对胰腺疾患诊断的敏感性分别为88.5%、73.1%、84.6%、92.3%、96.2%,特异性分别为66.7%、33.3%、66.7%、66.7%、83.3%,准确性分别84.4%、65.6%、81.3%、87.5%、93.8%。结论:18F-FDG PET/CT较单纯PET、单纯CT、增强CT对胰腺疾患的诊断价值高,综合手段能提高诊断的敏感性、特异性、准确性。Objective：To evaluate the diagnosis and differential diagnosis value of positron emission tomography / computed tomography （PET/CT） with fluorine-18-1abeled fluoredeoxygiucose （FDG）, enhanced cr and synthetic means on pancreatic earcinoma.Methods： A retrospective analysis was performed on 32 cases of patients having pancreatic neoplasm and panereatitis, all proved by surgery and clinical diagnosis. The form, density, size, enhancement degree, dilation of pancreatic duct, cholangiectasis and metastasis of pancreatic lesions on CT pictures were surveyed. The standard uptake value maximum （SUVmax） in region of interest （ROI） of pancreatic lesions were calculated. Images were interpreted and compared with the histopathologic findings at surgery or with clinical follow-up findings. The sensitivity, specificity and accuracy of simple PET, plain CT, enhanced CT, PET/CT and synthetic means diagnosis were analyzed.Re- stills：In the 32 cases of pancreatic lesions, there were 26 patients with pancreatic malignant neoplasm and 6 patients with benign lesions. Twenty six patients had pancreatic malignant neoplasm, among whom 20 were pancreatic carcinomas, 3 were postoperation recyrrence of pancreatic carcinoma, 2 were metastatic carcinoma of pancreas and 1- was potential malignancy. 6 patients had benign lesions, among whom 5 were inflammatory pancreatic tumor, 1 was acute pancrcatitis. 8 cases were metastatic in parapancreas and retroperitoneal lymph node, 4 in peritoneal cavity and mesentery, 7 in hepatic metastatic, and 2 in bone. The sensitivity of simple PET, simple CT, enhanced CT, PET/CT and synthetic means were 88.5% ,73.1% ,84.6% ,92.3% ,96.2% respectively. The specificity of simple PET, simple CT, enhanced CT, PET/CT and synthetic means were 66.7%.33.3% ,66.7% ,66.7% ,83.3% respectively. The accuracy of plain PET, plain CT, enhanced CT, PET/CT and synthetic means were 84.4% ,65.6% .81.3% ,87.5% ,93.8% respectively. Conclusion： PET/CT is of greater value to the diagnosis of pancreatic lesions t

关 键 词：肿块 胰腺 体层摄影术 X线计算机 正电子发射体层显像 脱氧葡萄糖 

分 类 号：R735.9[医药卫生—肿瘤] R445.2[医药卫生—临床医学]