^(18)F-FDG PET/CT在探查腹膜转移性肿瘤中的价值  

The role of ^(18)F-FDG PET/CT in detecting the peritoneal carcinomatosis

作　　者：吴建伟[1] 艾书跃[1] 朱虹[2] 袁梅[1] 夏梅花[1] 

机构地区：[1]解放军八一医院影像科 [2]南京军区南京总院核医学科,210002

出　　处：《临床肿瘤学杂志》2007年第11期852-855,共4页Chinese Clinical Oncology

摘　　要：目的:评价18F-FDG PET/CT探查腹膜转移瘤的价值。方法:39例有腹部原发恶性肿瘤手术史患者行PET/CT首次和延迟扫描,在PET/CT图像上记录病灶大小、分布,结果与常规CT比较。测量62个病灶和对照组32例腹部无病变患者的肠管SUVmax。所有病例经手术、病理、影像学和肿瘤标记物随访作出最后诊断。结果:最终确认39例中31例腹膜转移瘤,病灶均为结节状或沿腹膜条片状分布,多位于肝脏周围和盆腔腹膜,其他部位腹膜少见。PET/CT漏诊的4个病灶主要位于肝脏周围,1例因化疗不久病灶FDG低摄取而漏诊,因此敏感性为87.1%,特异性为87.1%。CT仅检出12例转移瘤。转移瘤SUVmax明显高于对照组肠管SUVmax(P=0.0000)。结论:18F-FDG PET/CT能够较CT更早、更多地检出腹膜转移瘤,病灶体积小、位于基础摄取较高的肝脏周围是漏诊主要原因,而结合原发肿瘤病史和肿瘤标记物检查有利于诊断。Objective：To evaluate the role of ^18F-FDG PET/CT in detecting the peritoneal carcinomatosis. Methods：The first and delay PET/CT scan were performed in 39 patients with the history of abdominal malignancy. The maximal standard uptake value （SUVmax） , diameter, location of 62 lesions were recorded and compared with those on CT,We also assessed most intense intestinal uptake of is F-FDG in 32 petinets without abdominal diesases as control. The final diagnoses of all cases were demonstrated by surgery, pathology or follow-up of CT, MRI, PET/CT and toumor markers. Results ： Twenty-eight of 31 patients defined as the peritoneal carcinomatosis finally were diagnosed correctly on PET/CT, all lesions showed nodosity or strip, most of them located in perihepatic and pelvic peritoneum, some of them in other areas. The lesions in 4 cases located in perihepatic peritoneum and one lesion with lower FDG-uptake after a cycle of chemotherapy were missed, so the sensitivity and specificity of PET/CT for peritoneal carcinomatosis were 87. 1% and 87.5%. Lesions in only 12 cases with diameter of 2 to 5cm were detected by CT. The SUVmax of lesions was heigher than that of intestinum in control group significantly （P = 0. 000 0）. Conclusion：TM F-FDG PET/CT can early detect the more peritoneal metastases than CT, the main cause of missed diagnosis was due to the lesion with small volume and located in perihepatic peritoneum which had similar metabolism with liver, relating the histiory of primmary malignancy, the level of toumor markers was favourable to the diagnoses.

关 键 词：腹膜转移瘤 诊断 ^18F-脱氧葡萄糖 PET/CT 

分 类 号：R730.44[医药卫生—肿瘤]