40层^(18)F-FDG PET/CT在直肠癌N分期中的应用  

Cinical role of ^(18)F-FDG PET/CT for nodal staging of rectal cancer

作　　者：张占文[1] 胡平[1] 张杰[1] 崔文民[1] 陈春[1] 

机构地区：[1]中山大学附属第六医院中山医康健影像检验中心核医学科,广州510610

出　　处：《重庆医学》2011年第8期778-780,F0003,共4页Chongqing medicine

摘　　要：目的评价40层18F-脱氧葡萄糖正电子发射体层摄影术(FDG PET)/CT对直肠癌淋巴结转移的诊断价值。方法回顾性分析31例经手术病理检查证实的直肠癌PET/CT表现,按解剖学定位统计直肠癌区域淋巴结的数目、大小、分布、代谢情况并与病理检查结果进行对比分析。结果同机40层CT以5、8、10 mm作为参考标准,诊断的灵敏度、特异度、准确性分别为84.6%、40.6%、53.3%,61.5%、87.5%、80.0%,28.8%、93.7%、75.0%;以淋巴结最大标准摄取值(SUVmax)1.0、2.0、3.0作为参考标准,诊断的敏感度、特异度、准确性分别为100%、37.5%、55.6%,90.4%、82.8%、85.0%,78.8%、95.3%、90.5%;二者结合对直肠癌N分期的诊断准确性为90%。结论 40层螺旋CT能清晰显示直肠癌区域淋巴结,对检出直肠癌淋巴结转移具有较高的灵敏性。以淋巴结短径为5~8 mm,结合淋巴结SUVmax(2.0~3.0)作为诊断参考标准,可明显提高18F-FDG PET/CT术前直肠癌N分期诊断的准确性。Objective To research the diagnostic value of 40-slice spiral ^18F-FDG PET/CT for lymph node metastasis of rectal cancer.MethodsFor 40 patients with rectal cancer who had final diagnosis of patholog,abnormal FDG uptake,associated lymph node diameter,unmber,distribution and maximum standardized uptake valus（SUVmax）and pathologic reiuels were comparatively analyred.Resultsthe sensitivity,specificity and accuracy by lymph node diameter using cutoff value of 5,8,10 mm were 4.6%,40.6%,53.3%;61.5%,87.5%,80.0%;28.8%,93.7% and 75.0% respectively,and those by SUVmax using cutoff value of 1.0,2.0,3.0 were 100%,37.5%,55.6%;90.4%,82.8%,85.0%;78.8%,95.3 and 90.5% respectively.combining two criteria,the accuracy was 90% by PET/CT.ConclusionLymph nodes in region of rectum can be shown clearly with 40-slice spiral ^18F-FDG PET/CT;Combining 5-8 mm cutoff value of lymph node diameter with 2.0-3.0 cutoff value of SUVmax may improve the accuracy of rectal cancer N staging.

关 键 词：直肠肿瘤 淋巴结 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：R735.37[医药卫生—肿瘤]