增强CT联合PET／CT在胰腺癌可切除性评价中的价值  

Enhanced CT and 18F-FDG PET/CT in evaluating resectability of pancreatic cancer

作　　者：潘树波[1] 赵红川[1] 谢坤[1] 耿小平[1] 

机构地区：[1]安徽医科大学第一附属医院器官移植中心,合肥230032

出　　处：《中华肝胆外科杂志》2013年第10期726-729,共4页Chinese Journal of Hepatobiliary Surgery

摘　　要：目的探讨增强CT与PET／CT在胰腺癌可切除性判断中的应用价值。方法回顾收治的31例经手术病理证实为胰腺癌的患者资料。所有患者术前均行增强CT和PET／CT扫描，比较二者及二者联合检查对胰腺癌可切除性评估的准确性。结果31例手术治疗的胰腺癌患者，18例行根治性切除（R0切除），其余13例因术中发现不可切除因素行姑息性手术。在胰腺周围血管侵犯判断方面，增强CT准确度为87．0％。在胰周淋巴结转移判断方面，增强CT和PET／CT的准确度分别为48．3％和64．5％，二者在判断区域淋巴结转移的差异有统计学意义（P=0．042）。增强CT对胰腺癌可切除判断的灵敏度、特异度和准确度分别为94．4％、15．3％和61．2％；PET／CT的灵敏度、特异度和准确度分别为94．4％、38．4％和70．9％，二者差异无统计学意义（P=0．375）。联合检查判断的灵敏度、特异度和准确度分别为88．8％、53．8％和71．3％，显著优于单独增强CT或PET／CT，差异有统计学意义（P=0．006和P=0．039）。结论增强CT在判断肿瘤周围血管侵犯方面准确度较高，而PET／CT在胰腺周围淋巴结转移方面准确度较高，联合检查可进一步提高胰腺癌可切除性判断的准确度。Objective To study 18F-FDG PET/CT and enhanced CT in the evaluation of resect- ability of pancreatic cancer. Methods The 18F-FDG PET/CT and enhanced CT images of patients with pancreatic cancer were analyzed and the results in assessing resectahility were compared. The di- agnosis of pancreatic cancer and resectability were confirmed by intraoperative findings and histopathology. Results 31 patients with pancreatic cancer underwent surgery. Complete resection of the tumor was successfully carried out in 18 patients. Palliative operations were performed in the remaining 13 patients because the tumors were unresectable. The sensitivity, specificity and accuracy for unresectability were 94.4%, 15.3%, 61.2% using enhanced CT, 94.4%, 38.4%, 70.9% using 18F-FDG PET/CT, and 88.8%, 53.8%, 71.3% using a combination of these two examinations, respectively. There was no significant difference between enhanced CT and 18 F-FDG PET/CT. A combination of these two examinations was significantly better than either one of these examinations. Conclusions Either enhanced CT or 18F-FDG PET/CT was useful, and they complemented each other in assessing resectability of pancreatic tumor. A combination of these two examinations was more evaluable than either one of these examinations.

关 键 词：胰腺肿瘤 胰腺切除术 体层摄影术 X线计算机 

分 类 号：R735.9[医药卫生—肿瘤]