^18F-FDG PET／CT显像在恶性胸膜间皮瘤诊断中的价值  

Application of PET/CT imaging in the diagnosis of malignant pleural mesothelioma

作　　者：刘松涛[1] 柳澄[2] 姚树展[1] 韩广秀[1] 黄葵红[1] 宁国庆[1] 李昕[1] 

机构地区：[1]山东大学附属省立医院PET/CT中心,济南250021 [2]山东省医学影像研究所

出　　处：《中华核医学杂志》2009年第3期171-173,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨^18F-脱氧葡萄糖（FDG）PET／CT显像在恶性胸膜间皮瘤（MPM）诊断中的临床价值及原发肿瘤病灶平均标准摄取值（SUVmean）对患者预后的判断价值。方法回顾性总结17例2002—2008年临床疑诊MPM患者^18F-FDG PET／CT显像资料，测量病灶的SUVmean。将病理检查及临床随访证实的MPM患者按照有无转移分为2组，测定每例患者原发肿瘤病灶的SUVmean，用受试者工作特征（ROC）曲线评价SUVmean对患者转移与否的诊断价值，判断预后。采用SPSS11．0软件进行t检验。结果经病理及随访结果证实MPM12例，良性胸膜病变5例，二者的SUVmean分别为5．78±1．81和2．72±2．51，差异有统计学意义（t=2．8，P〈0．05）。全身^18F-FDG PET／CT显像诊断MPM的灵敏度为100％（12／12），特异性为4／5，准确性为94％（16／17）。^18F-FDG PET／CT显像有7例MPM伴有骨和（或）淋巴结转移。SUVmean ROC曲线分析表明曲线下面积（AUC）为0．80。结论全身^18F-FDG PET／CT显像对于MPM的诊断有重要价值。原发肿瘤病灶SUVmean越高越易发生转移，预后越差。Objective Malignant pleural mesothelioma （MPM） is an uncommon neoplasm arising from mesothelial cells of the pleura. The prognosis is poor with median survival of 4- 12 months. The aim of this study was to evaluate the clinic value of ^18F-fluorodeoxyglucose （FDG） PET/CT imaging in the diagnosis and to staging of MPM and to determine if the mean standardized uptake value （ SUV ） of primary tumor correlates with staging and prognosis. Methods Study was conducted retrospectively including 17 patients with clinical suspicion of MPM from 2002 to 2008. Twelve cases of MPM and 5 cases benign pleural pathology were proven by histopathology and clinical follow-up. ^18F-FDG PET/CT imaging was performed 1 h after injection of 7.4 MBq/kg ^18F-FDG. Patients with MPM confirmed by histopathology were divided into two groups： with and without metastasis. PET/CT findings were analyzed to determine if SUVmean of primary tumor correlates with staging and prognosis. Receiver operating characteristic （ ROC） curve of SUVmean of primary tumor was evaluated to determine if it was a predictor of metastasis and survival time. Results The difference in SUVmean between MPM and benign plcural were statistical significant （5.78 ± 1.81 vs 2.72 ± 2.51, t = 2. 8, P 〈 0.05 ）. The diagnostic sensitivity, specificity and accuracy of ^18F-FDG PET/CT imaging for MPM were 100% （ 12/12）, 4/5 and 94% （16/17）. All 7 cases of bone and lymph node metastases were detected by ^18F-FDG PET/CT imaging. Area under the curve （AUC） was 0. 80. Conclusions ^18F-FDG PET/CT imaging is useful in the diagnosis and staging of MPM. High SUVmean in the primary tumor correlates well with prognosis and predication of a greater propensity to have nodal and distant metastasis.

关 键 词：胸膜肿瘤 体层摄影术 发射型计算机 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R686[医药卫生—骨科学]