^(11)C-乙酸盐PET显像在肾脏肿瘤诊断中的作用  

The role of ^(11)C-acetate PET imaging for diagnosis of renal cancer

作　　者：霍力[1] 周前[1] 吴战宏[1] 肖河[1] 卢朝辉[1] 李汉忠[1] 

机构地区：[1]中国医学科学院

出　　处：《中华核医学杂志》2006年第4期205-208,共4页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨 ^(11)C-乙酸盐 PET 显像在肾脏肿瘤诊断中的作用及其与^(18)F-脱氧葡萄糖(FDG)肾肿瘤显像的关系。方法 29例疑肾肿瘤患者行 ^(11)C-乙酸盐 PET 早期及延迟显像,其中22例1周内行 ^(18)F-FDG PET 显像。所有患者均有手术病理检查或 CT、随访结果。患者静脉注射 ^(11)C-乙酸盐后即刻采集肾脏部位早期图像,以反映肾皮质血流灌注;10 min 后采集延迟图像,以反映 ^(11)C-乙酸盐在肾皮质内的代谢。观察 ^(11)C-乙酸盐在人体内的分布,并比较 ^(11)C-乙酸盐与 ^(18)F-FDG 肾肿瘤显像的阳性率及其与病理类型、分级的关系。结果 ^(11)C-乙酸盐在人体内以胰腺摄取最高,并可能经胰液分泌入肠道。肾皮质对 ^(11)C-乙酸盐摄取随时间而变化,延迟相大部分原发肾皮质肿瘤(13例中分级Ⅰ～Ⅱ为12例)对 ^(11)C-乙酸盐摄取高于正常肾皮质,阳性率为76.9%(10/13例);而 ^(18)F-FDG 显像仅为30.8%(4/13例)。6例肾盂输尿管移行细胞癌 ^(11)C-乙酸盐显像阳性仅2例;其中5例行 ^(18)F-FDG 显像,均阳性。1例肾血管平滑肌脂肪瘤 ^(11)C-乙酸盐早期及延迟显像均清晰显示,2例输尿管炎症对 ^(11)C-乙酸盐无摄取。结论 ^(11)C-乙酸盐 PET 显像对恶性程度较低的肾皮质肿瘤显像阳性率较高,可弥补 ^(18)F-FDG 显像的不足。Objective To evaluate the relationship between ^11C-acetate and ^18F-fluorodeoxyglucose （FDG） for the detection of renal neoplasm and to determine the feasibility of ^11C-acetate used as a complement of ^18F-FDG, Methods Twenty-nine patients with 25 primary lesions underwent ^11C-acetate （ 111～655 MBq intravenous injection） PET imaging （early imaging after injection instantly, and delayed imaging 10 min latter） , and among them 22 patients underwent ^18F-FDG PET imaging within one week, Twenty-five primary and three metastatic lesions were confirmed histologically. One metastasis was proved by CT and clinical follow-up. Thirteen renal clear cell carcinoma and six transitional cell carcinoma lesions had patho- logic grading. Results Among all human organs, pancreas showed persistent highest uptake of ^11C-acetate. Activity in bowel was due to the pancreatic excretion. High accumulation was also observed in renal cortex initially but was cleared rapidly, while most primary lesions of renal cell carcinoma showed radioactive hot areas in delayed images. Compared with ^18F-FDG （30.8% positively）,^11C-acetate was more sensitive in detecting primary lesions of renal cell carcinoma （76.9% positively）. However, ^18F-FDG was an effective tracer in the diagnosis of transitional cell carcinoma, since 5 （5/5） of them were all visualized while only 2 （2/6） were demonstrated in ^11C-acetate imaging. One renal angiomyolipoma was both positive in early and delayed imaging of ^11C-acetate, but ureteritis was negative. Conclusions ^11C-acetate is more sensitive than ^18F-FDG for the detection of well differentiated renal cell carcinoma, especially for grade Ⅰ ～ Ⅱ. Therefore, ^11C-acetate imaging can be used as a complement for ^18F-FDG.

关 键 词：肾肿瘤 体层摄影术 发射型计算机 乙酸盐类 脱氧葡萄糖 

分 类 号：R737.11[医药卫生—肿瘤]