PET/CT融合图像在体部转移性肿瘤中的诊断价值——与CT、SPECT或PET的比较研究  

The diagnostic value of PET/CT fusion images in metastatic tumors of the body: research based on the comparison of CT,SPECT or PET images

作　　者：文明[1] 彭志平[2] 柏玮[3] 李少林[2] 彭云[4] 陈刚[5] 

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016 [2]重庆医科大学基础医学院放射医学教研室,重庆400016 [3]重庆医科大学 [4]华蓥市广能医院放射科,四川638500 [5]重庆医科大学附属第一医院核医学科,重庆400016

出　　处：《重庆医科大学学报》2006年第5期742-746,共5页Journal of Chongqing Medical University

摘　　要：目的:通过与CT、SPECT或PET图像的对比研究,探讨PET/CT融合图像在诊断体部转移性肿瘤中的价值。方法:收集经手术或活检后病理证实的体部转移性肿瘤共19例60个病灶,所有病例均经CT、SPECT或PET、PET/CT扫描等手段检查,其中CT检查19例,平扫9例,另10例加做增强扫描;SPECT检查11例,其余8例为PET检查;PET/CT检查19例。分别在这些图像上观察并记录肿瘤病灶的数目、位置、大小、放射性核素分布、有无淋巴结增大或局部软组织肿胀等情况。结果:9例转移性肺癌,PET/CT检出率为100%(29/29个),SPECT或PET为86.2%(25/29个),CT为82.8%(24/29个);7例脊柱转移性肿瘤,PET/CT检出100%(17/17个),SPECT或PET为88.2%(15/17个),CT为76.5%(13/17个);3例转移性肝癌,检出率分别为PET/CT 100%(14/14个),SPECT或PET 71.4%(10/14个),CT 78.6%(11/14个)。结论:CT图像能清晰显示病灶的形态、解剖部位;核医学图像如SPECT、PET可提供病灶的生物功能信息;PET/CT融合图像,既可以显示病灶的形态、结构变化,又能得到功能信息,从而提高了定位、定性诊断和鉴别生理性摄取的能力。Objective：To evaluate the diagnostic value of PET/CT fusion images in the research field of metastatic tumors of the body by the comparison of CT, SPECT or PET images.Methods：The analysis was based on 19 cases with 60 metastatic lesions. The final diagnoses were confirmed by surgery, biopsy and pathology. CT, SPECT or PET and PET/CT were applied in all cases. CT scanning was applied in 19 cases. Among them,there were 9 plain examinations,and on the basis of that,the other 10 cases were applied enhancement scanning. SPECT was applied in 11 cases.Among them, there were also another 8 cases which were applied PET.Combined PET/CT examinations were performed in 19 cases. PET/CT was separately compared with CT, SPECT or PET findings,and the its numbers,localization,size,the distrubution of radionuclide, the involvement of lymph node and local swelling of soft tissues of the lesions were recorded. Results： There were 9 cases of pulmonary metastasis and the detective rate of PET/CT was 100% （ 29/29 cases ）, SPECT or PET 86.2%（25/29 cases）, CT 82.8% （ 24/29 cases ） ; 7 cases of spine metastasis and the detective rate of PET/CT was 100% （ 17/17 cases ）, SPECT or PET 88.2% （ 15/17 cases ）, CT 76.5% （13/17 cases）; 3 cases of hepatic metastasis, and the detective rate of PET/CT was 100% （ 14/14 cases ）, SPECT or PET 71.4%（10/14 cases）, CT 78.6% （11/14 cases）respectively.Conclusion：The shape and anatomic position of metastatic lesion can be clearly detected on CT image; nuclear medicine images such as SPECT,PET can provide excellent information on functional biology. Referring to PET/CT,it is a very useful method in detecting lesions of the shape and construction,and it can also provide more functional information,localization and characterization of metastatic lesion, PET/CT image can differentiate physiologic uptake,and meanwhile promote the differentiation of its physiologic intake.

关 键 词：转移性肿瘤 断层摄影术 X线计算机 体层摄影术 发射型计算机 单光子发射计算机断层 图像融合 

分 类 号：R817.4[医药卫生—影像医学与核医学]