^18F-FDGPET／CT对原发性腹膜乳头状浆液性癌的诊断价值  

Clinical value of 18F-FDG PET/CT in the diagnosis of primary peritoneal papillary serous carcinoma

作　　者：林志春[1] 尹亮[1] 何滔[2] 张冬菊[1] 张庆[1] 穆海玉[3] 

机构地区：[1]武警后勤学院附属医院PET/CT中心,天津300162 [2]武警后勤学院附属医院病理科,天津300162 [3]武警后勤学院附属医院肿瘤中心,天津300162

出　　处：《中华核医学与分子影像杂志》2013年第5期324-327,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨^18F—FDGPET／CT显像在诊断原发性腹膜乳头状浆液性癌（PPPSC）中的价值。方法回顾性分析2009年3月至2011年10月在PET／CT中心检查并经病理确诊的10例绝经期女性PPPSC患者，年龄61～81（69．4±6．2）岁。患者均行^18F—FDGPET／CT显像，分析其病灶CT表现及PET的SUVmax，观察PPPSC的PET／CT表现，并与病理结果进行对比分析，同时测定PET／CT检查前或后1周内患者血清CA125，采用直线相关分析，评估壁腹膜、大网膜、肠系膜三者中最大的SUVmax与CA125的相关性。结果10例PPPSC患者^18F—FDGPET／CT显像主要表现为：10例患者大网膜呈絮状、多发结节状及饼状软组织密度不均匀增高及代谢增强（SUVmax为6．32＋2．87）；9例壁腹膜及8例肠系膜呈弥漫性或局限性结节状或条状软组织不均匀增厚及代谢增强（SUVmax分别为5．96±2．14和5．70±1．69），其中壁腹膜以盆壁腹膜受累为主，肠系膜以小肠系膜受累为主；10例患者均有不同程度的腹腔积液，以肝周及盆腔为主；2例双侧卵巢及1例右侧卵巢稍增大，最大直径均在5cm以内，同时伴有代谢异常增高；4例腹膜后淋巴结转移；出现点状钙化灶、有少量胸腔积液、有肝脏转移、伴有肝门淋巴结转移各2例。所有患者CA125均增高[（51．25±26．40）×10^4U／L]，CA125与壁腹膜、大网膜及肠系膜三者中最大SUVmax无明显相关性（r=0．05，P〉0．05）。结论PET／CT显像可显示PPPSC病灶部位，也能反映病灶的代谢状态，可用于PPPSC的辅助诊断。Objective To explore the diagnostic value of 18F-FDG PET/CT in primary peritoneal papillary serous carcinoma （PPPSC）. Methods Ten postmenopausal female cases of pathologically diagnosed PPPSC from March 2009 to October 2011 were retrospectively reviewed （age range： 61-81 years, mean： （69.4±6.2） years）. All cases underwent ISF-FDG PET/CT. The CT characteristics and SUVmax of lesions on PET images were analyzed. Serum CA125 levels were measured before or after PET/CT within one week. The patterns of PPPSC on PET/CT were compared with histopatbological results. Linear correlation analysis was used to evaluate the correlation between the CA125 and the maximum SUVmax of lesions presented in parietal peritoneum, greater omentum or mesentery. Results The PET/CT uptake pattern of the 10 PPPSC cases was described as floccus, multi-nodular or cake-like in greater omentum （SUVmax = 6. 32±2.87）, and as diffuse or localized nodules, or non-uniform strip-like thickening in 9 parietal peritoneum and 8 mesentery cases （SUVmax = 5.96±2. 14 and 5.70±1.69, respectively）. The most commonly involved sites were pelvic wall of peritoneum and mesentery of small intestine. All 10 cases had different degrees of ascites, mainly intrapelvic and perihepatic. Hypermetabolic ovarian enlargement （all 〈5 cm） was bilateral in 2 patients and right-sided in 1 patient. Four patients had retroperitoneal lymph node metastasis and others were found with punctate calcifications in metastatic lymph nodes, small pleural effusions, liver metastasis, as well as portal node metastasis. CA125 concentration was elevated in all cases （（51.25± 26.40） ×10^4 U/L）, but there was no significant correlation between CA125 and the maximum SUVmax of lesions found in parietal peritoneum, greater omentum or mesentery （r = 0.05, P〉0.05 ）. Conclusion 18 F-FDG PET/CT could show the positions and metabolic status of PPPSC lesions. It may be an effective imaging modality in the diagnosis and assessment of PPPSC.

关 键 词：腹膜肿瘤 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：R735.5[医药卫生—肿瘤]