^(18)F-FDG PET-CT与增强CT在胰腺病变良恶性鉴别及胰腺癌分期中的价值对比研究  

Comparative study of ^(18)F-FDG PET/CT and contrast-enhanced CT in diagnosing and staging assessment of pancreatic cancer

作　　者：余仲飞[1] 方艺[2] 张建[2] 左长京[2] 杨剑[2] 吴仪仪[2] 程超[2] 崔斌[2] 董爱生[2] 孔令山[2] 

机构地区：[1]第二军医大学长海医院放射科,上海200433 [2]第二军医大学长海医院核医学科,上海200433

出　　处：《医学影像学杂志》2013年第8期1236-1240,共5页Journal of Medical Imaging

基　　金：中国博士后基金(20100480545);上海市科委国际合作基金(10410708800);国家自然基金(81170435)

摘　　要：目的探讨18F-FDG PET/CT与增强CT(CECT)在胰腺良恶性病变鉴别及胰腺癌分期中的价值。方法回顾性分析治疗前在我院行CECT和PET/CT检查的胰腺病例(时间间隔≤2周),并以病理及临床影像随访结果作为金标准,比较CECT、PET/CT对胰腺病变良恶性鉴别诊断以及胰腺癌TNM分期的灵敏度、特异度及准确率。结果共入选病例68例,其中男43例,女25例,恶性48例,良性20例。良性病变组SUVmax平均5.06(范围1.10～29.10),恶性病变组SUVmax平均7.80(范围1.60～17.60)。CECT与最终诊断有中度一致(κ=0.414,P<0.05);PET/CT与最终诊断有较高度的一致性(κ=0.677,P<0.05)。术前CECT和PET/CT诊断胰周血管侵犯的灵敏度、特异度、准确率分别为(92.9%、93.3%、93.1%)vs(21.4%、93.3%、58.6%)。CECT和PET/CT诊断区域淋巴结转移的灵敏度、特异度、准确率分别为(64.7%、91.7%、75.9%)vs(76.5%、83.3%、79.3%)。CECT和PET/CT诊断远处转移的灵敏度、特异度、准确率分别为(58.8%,100%,85.4%)vs(88.2%,96.8%,93.7%)。结论 PET/CT在胰腺恶变的诊断中具有更高的敏感性和特异性,对远处转移的有更高的敏感性;而CECT可以精确地显示肿瘤与血管的关系、对远处转移的有更高的特异性,两者各有优势不能相互取代,临床工作中需要我们根据患者的实际情况合理选择,必要时联合应用,更好地发挥它们的优势。Objective To investigate the value of 18F-FDG PET / CT and enhanced CT （CECT） in differentiating malig- nant or benign pancreatic and staging of pancreatic cancer. Methods We retrospectively analysed of pre-treatment pancre- as cases in our hospital which have CECT and PET/CT examination imaging （interval l 2 weeks）. Using the gold stand- ard of pathology and clinical imaging follow-up results, we compared the sensitivity, specificity and accuracy of CECT and PET/CT in differential diagnosising the pancreatic lesions, and TNM staging of pancreatic cancer. Results 68 cases were enrolled, 43 cases were males and 25 females. There were 48 cases of malignant and benign 20 cases. In benign lesions group, the SUVmax average was 5.06 （range 1.10±29.10）, in malignant lesion group, the SUVmax average was 7.80 （range 1.60±17.60）. Concordance of CECT with final diagnosis was moderate （ r = 0. 414, P 〈0.05） ; Concordance of PET/CT with final diagnosis was higher （ K = 0. 677, P 〈0.05）. CECT and PET / CT in the preoperative diagnosis of peripancreatic vascular invasion, sensitivity, and specificity, and accuracy were （92.9%, 93.3 %, 93.1 %） vs （21.4 %, 93.3%, 58.6%） respectively. CECT and PET / CT diagnosis of regional lymph node metastasis, the sensitivity, specific- ity, accuracy were （64.7%, 91.7%, 75.9%） vs （76.5%, 83.3%, 79.3%） respectively. The CECT and PET/CT diag- nostic sensitivity, specificity, and accuracy rate of distant metastasis were （58.8~, 100%, 85.4%） vs （88.2%, 96.8%, 93.7%） respectively. Conclusion PET / CT in the diagnosis of malignant in the pancreas has higher sensitivity and speci ficity, for distant metastasis has higher sensitivity. CECT can accurately show the relationship between the tumor and the blood vessels, and higher specificity for distant metastasis, the two methods both have their advantages, and can not re- place each other. In clinical work, we should choose or combine them according to the patient＇s specific circumstances, in order

关 键 词：胰腺病变 正电子发射断层显像 体层摄影术 X线计算机 对比增强 影像诊断 

分 类 号：R657.5[医药卫生—外科学] R814.42[医药卫生—临床医学]