^(18)F-FDG PET/CT显像在肝脏恶性肿瘤的初步应用  

Clinical applications of ^(18)F-FDG PET/CT in detecting hepatic malignant tumors

作　　者：艾书跃[1] 吴建伟[1] 吕毛古[1] 王灵枝[1] 杨军[1] 黄伟[1] 袁梅[1] 

机构地区：[1]解放军八一医院医学影像科,南京210002

出　　处：《临床肿瘤学杂志》2007年第4期279-281,284,共4页Chinese Clinical Oncology

摘　　要：目的:评价18F-FDGPET/CT对于肝脏恶性肿瘤的诊断、分期及疗效评判的价值。方法:对55例肝脏恶性肿瘤患者的PET/CT检查资料进行回顾性分析。原发性肝细胞性肝癌(PHC)11例,胆管细胞性肝癌1例,转移性肝癌40例,白血病肝浸润1例,淋巴瘤肝浸润2例。其中原发性肝癌经手术或穿刺证实,继发性肝脏恶性肿瘤均有明确肿瘤病史或临床检查随访证实。所有患者均行双时相全身PET/CT显像检查。结果:低分化PHC4例及胆管细胞癌1例,18F-FDG异常高摄取,延迟后大部分病灶18F-FDG摄取SUVmax上升;高分化原发性肝癌7例,其中18F-FDG等摄取5例,相对肝本底为略低摄取2例;9例PHC及1例胆管细胞癌CT表现为低密度灶,2例PHC为等密度,7例患者有肝炎肝硬化基础,另外同时发现肝外病灶6例。继发性肝脏恶性肿瘤43例(含淋巴瘤、白血病肝浸润)中PET/CT上共发现109个病灶;其中99个肝内病灶表现为18F-FDG高摄取,31个病灶CT未显示,另外有2例患者有4个病灶经手术证实有肝内微小病灶而PET/CT未检出;而淋巴瘤、白血病肝浸润表现为大片状或弥漫性18F-FDG明显异常高摄取;大部分患者改变了原有的治疗方案。结论:18F-FDGPET/CT在肝脏恶性肿瘤诊断、分期、评价分化程度及治疗方案的选择有较好的临床价值,PET/CT诊断肝脏恶性肿瘤明显优于单纯PET。充分认识PET/CT在肝脏恶性肿瘤中的应用价值及局限性,有利于临床对肝脏恶性肿瘤的诊治。Objective：The objective of our study is to assess the roles of ^18F-FDG PET/CT in the diagnosis,staging and monitoring response to therapy in hepatic malignant lesions. Methods：Imaging data of 55 patients with hepatic malignant lesions who had undergone whole-body ^18F-FDG PET/CT were retrospectively reviewed. The study included 11 cases primary hepatio cellular（PHC） , 1 case with cholangiocellular carcinoma ,40 cases with metastatic hepatic carcinoma（MHC）, 1 case with leukemia infiltration of liver and 2 cases with lymphoma infiltration of liver＋ Surgery, histopathology or follow-up imaging served as the standard of reference. Resuits ：The lesons in 4 cases of poorly differentiated PHC and 1 case cholangiocellular carcinoma showed intense FDG uptake in ^18F-FDG PET/CT scan, and increased uptake on delay PET/CT; The lesons in 7 cases of well differentiated PHC showed low uptake or uptake as normal liver 9 of PHC and cholangiocellular carcinoma CT finding showed low density ,2 of them showed isodensity; 7 of PHC were developed through malignant transformation of cirrhosis ; Extrahepatic metastatic diseases were detected in 6 cases of PHC. The 99 of 109 lesions in 43 cases MHC （included leukemia or lymphoma infiltration of liver） showed intense FDG uptake; CT imaging showed 78 lesions,4 lesions of 2 cases in hepatic metastatic lesions confirmed by surgery showed nagative on PET/CT; In addition, leukemia or lymphoma infiltration of liver showed patches or diffuses intense FDG uptake. These diagnostic advantages resulted in the change of tumor staging and therapeutic planning in a substantial. Conclusion：PET/CT was an excellent modality in the diagnosis, staging , assessing the differentiation degree and monitoring treatment response of hepatic malignant lesions. It is illustrated that F-18 FDG PET/ CT improves the diagnostic performance compared with PET alone. To achieve understanding of the application value and limitations with PET/CT fully is favour of clinically detecting the liver maligna

关 键 词：肝脏恶性肿瘤 诊断 PET/CT ^18F-FDG 

分 类 号：R735.7[医药卫生—肿瘤]