^(18)F-FDG PET/CT和MRI对鼻咽癌诊断价值的比较  

Comparison of diagnostic value between ^(18)F-FDG PET/CT and MRI in nasopharyngeal carcinoma

作　　者：林秋玉[1] 赵红光[1] 赵继红[1] 林承赫[1] 

机构地区：[1]吉林大学第一医院核医学科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2009年第6期1163-1166,共4页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科研基金资助课题(200705150)

摘　　要：目的:比较18F-FDG PET/CT和MRI在鼻咽癌TNM分期中的诊断价值,阐明18F-FDG PET/CT标准化摄取值(SUV)与鼻咽癌T分期和病理类型的关系。方法:41例鼻咽癌患者行18F-FDGPET/CT全身扫描,且于3周内行头颈部MRI检查。按照国际通用的美国癌症联合委员会(AJCC)鼻咽癌TNM分期标准对病变分别行MRI、PET/CT分期,并将组织病理结果作为参照标准。结果:①原发肿瘤:PET/CT诊断鼻咽癌T分期的准确率为85.37%,MRI的准确率为60.98%,两者比较差异有显著性(U=2.49,P<0.05);结合病理结果提示,PET/CT降低分期3例,提高分期7例;鼻咽癌患者原发灶SUV值与鼻咽癌T分期呈明显正相关关系(rs=0.706,P<0.05)。未分化癌患者SUV值明显高于低分化鳞癌,两组间比较差异有显著性(t=7.89,P<0.05)。②淋巴结转移:41例患者共切取淋巴结139枚,其中PET/CT正确判断阳性72枚,阴性56枚,灵敏度和特异度分别为93.51%和90.32%;MRI正确判断阳性60枚,阴性51枚,灵敏度和特异度分别为80.00%和79.69%;PET/CT诊断淋巴结转移的准确率为92.09%,MRI诊断淋巴结转移的准确率为79.86%,两者比较差异有显著性(U=2.93,P<0.05)。③远处转移:41例患者18F-FDG PET/CT全身扫描结果中,2例患者出现肝脏和骨骼远处转移灶,而MRI因扫描部位的限制未能显示。结论:18F-FDG PET/CT对鼻咽癌的TNM分期较MRI更全面、可靠。Objective To determine whether the use of 18F-FDG PET/CT alters staging and management of nasopharyngeal carcinoma （NPC） when compared with MRI staging practice;and to explore the relation of standard uptake value （SUV） of 18F-FDG PET/CT and the pathological classification and T staging of NPC. Methods The study was performed retrospectively on a group of 41 patients with a new diagnosis of NPC. All the patients underwent whole body PET/CT scanning and head ＆ neck MRI scanning within 3 weeks of each other. The AJCC protocol was introduced to stage NPC and the results of the PET/CT were compared with MRI based on pathologic diagnosis. Results ①Primary tumor：the accuracy of T staging of PET/CT was significantly higher than MRI （85.37% vs 60.98%,U=2.49,P〈 0.05）. According to the pathologic results,PET/CT downstaged 3 patients and upstaged 7 patients. In the patients with NPC,the SUV had positive correlation with T staging （rs=0.706,P〈0.05）; the SUV in the patients with undifferentiated carcinoma was significantly higher than that in the patients with poorly differentiated squamous carcinoma （t=7.89,P〈0.05）. ②Lymph nodes metastases：among all the 41 cases,139 lymph nodes were obtained. PET/CT correctly detected 72 positive lymph nodes and 56 negative lymph nodes,the sensitivity and specificity were 93.51% and 90.32%,respectively; while MRI correctly detected 60 positive lymph nodes and 51 negative lymph nodes,the sensitivity and specificity were 80.00% and 79.69%,respectively. The accuracy of N staging of PET/CT was significantly higher than MRI（92.09% vs 79.86%,U=2.93,P〈 0.05） ③Distant metastases：Among the 41 patients,2 patients with liver and bone metastases were detected by PET/CT,which missed by MRI. Conclusion 18F-FDG PET/CT stages NPC more accurately and sensitively than does MRI.

关 键 词：鼻咽肿瘤 ^18F-FDG PET/CT 标准化摄取值 磁共振成像 TNM分期 

分 类 号：R445.1[医药卫生—影像医学与核医学]