^18F—FDG PET-CT在肾上腺转移癌诊断中的价值及其诊断标准探讨  

Diagnostic value and diagnostic criteria of 1SF-FDG PET-CT in adrenal metastasis

作　　者：罗家伦[1] 徐慧琴[1] 何延辉[1] 薛央扬[1] 赵学峰[1] 岳峤[1] 

机构地区：[1]安徽医科大学第一附属医院核医学科,合肥230022

出　　处：《国际放射医学核医学杂志》2012年第2期87-91,共5页International Journal of Radiation Medicine and Nuclear Medicine

基　　金：安徽省科技计划项目（10021303025）

摘　　要：目的研究^18F—FDGPET—CT对肾上腺转移性癌的诊断价值，并探讨其最佳诊断标准。方法对59例术后病理或临床随访确诊为肾上腺转移癌及18例肾上腺良性病变患者行^18F—FDGPET—CT检查，分别测量肾上腺病灶的大小、SUVmax及正常肝组织的SUVmax，进行综合分析。结果59例肾上腺转移癌患者共78个肾上腺病灶，SUVmax为7．05±5．26，18例良性病变患者共21个肾上腺病灶，SUVmax为2．27±1．35，两者之间的差异有统计学意义（t=7．199，P〈0．01）；肾上腺转移癌与良性病灶的大小（短径）分别为（1．52±1．05）cm和（1．66±0．91）cm，两者之间的差异无统计学意义（t=0．529，P〉0．05）。受试者工作特征曲线分析，以肾上腺病灶SUVmax〉3．1作为良恶性的诊断标准，其诊断灵敏度、特异度和准确率分别为83．3％、90．5％和84．9％；以肾上腺病灶suvmax与正常肝组织的SUVmax比值〉1作为良恶性诊断标准，则诊断的灵敏度、特异度、准确率分别为96．2％、90．5％和95．0％；肾上腺转移癌病灶大小（短径）与其suVmax相关系数为0．501。肾上腺转移癌在双侧肾上腺的分布比例为：左侧30例（50．8％），右侧10例（17．0％），双侧19例（32．2％）。结论mF—FDGPET—CT对于肾上腺转移瘤的诊断具有较高的灵敏度及准确率；以肾上腺病灶suvmax与正常肝组织的SUVmax比值〉1为标准，可较好地诊断出肾上腺转移瘤的良恶性；肾上腺转移癌病灶的大小与其SUVmax有一定相关性，病灶常累及左侧。Objective To investigate the value of ^18F-FDG PET-CT in the diagnosis of the adrenal metastasis and study its diagnostic criteria. Methods Fifty-nine patients with adrenal metastasis and 18 patients with adrenal benign tumor underwent 18F-FDG PET-CT, all of the adrenal lesion＇s diameter and FDG maximum standardized uptake values （SUVmax）, SUVmax of normal liver were measured and analyzed com- prehensively. All lesions underwent biopsy after operation or follow-up in clinic or imaging diagnosis for final diagnosis. Results There were 78 adrenal lesions of 59 cases with adrenal metastasis, and 21 adrenal lesions of 18 cases with adrenal benign. The SUVmax of adrenals metastasis was 7.05±5.26, while benign tumor was 2.27±1.35, statistical significant difference was found between the 2 groups （t=7.199, P〈0.01）. The short diameter of adrenal metastasis was （ 1.66±0.91 ） cm, benign tumor was （ 1.52±1.05 ） cm, there was no statistical significant difference between the 2 groups （t=0.529, P〉0.05）. Receiver operator characteristic curve analysis showed that using lesion＇s SUVmax 〉3.1 as the diagnostic criteria of benign and metastatic adrenal lesions, the sensitivity, specificity and accuracy of 18F-FDG PET- CT in diagnosis of adrenals metastasis were 83.3%, 90.5% and 84.9%, respectively. But if using the SUVmax of adrenal lesion exceeds normal liver tissue as the diagnostic criteria, the sensitivity, specificity and accuracy were 96.2%, 90.5% and 95.0%. For adrenals metastasis, the correlation coefficient between lesion size （short diameter） and SUVmax was 0.501. Among all 59 cases with adrenal metastasis, 30 （50.8%） patients lesions in the left adrenal gland, 10 （16.9%） in the right side and 19 （32.2%） in the both sides. Conclusion 18F-FDG PET-CT has high sensitivity and accurate in diagnosis of adrenal metastasis, and the SUVmax, of adrenal lesion exceeds normal liver tissue is a better diagnostic criteria. The size of adrenal metastasis lesions has certain correlation

关 键 词：肾上腺肿瘤 肿瘤转移 正电子发射断层显像术 体层摄影术 x线计算机 氟脱氧葡萄糖F18 

分 类 号：R736.6[医药卫生—肿瘤]