^(18)F-FDGPET-CT在多浆膜腔积液探查肿瘤原发灶中的价值  

Value of ^(18)F-FDG PET-CT in detection of original disease of polyserositis

作　　者：周颖[1] 徐文贵 宋秀宇 戴东 刘建井 

机构地区：[1]天津医科大学肿瘤医院,国家肿瘤临床医学研究中心,天津市"肿瘤防治"重点实验室

出　　处：《中国实验诊断学》2014年第3期386-390,共5页Chinese Journal of Laboratory Diagnosis

基　　金：天津市自然科学基金重点项目资助(08JCZDJC23700);天津市教委课题资助(20080133)

摘　　要：目的探讨18F脱氧葡萄糖正电子发射体层摄影术(18F-FDG PET-CT)全身显像在可疑恶性肿瘤所致多浆膜腔积液中的应用价值。方法回顾性分析2006年6月至2013年6月期间84例以多浆膜腔积液为首发症状临床可疑恶性肿瘤患者的PET-CT显像资料,并将显像结果与病理及临床随访结果进行对比分析。结果 84例患者中有62例经病理及临床随访证实为恶性。84例多浆膜腔积液患者中胸水+腹水42例,胸水+心包积液30例,腹水+心包积液6例,胸水+腹水+心包积液6例,胸水合并腹水以卵巢癌、腹膜癌及肺癌多见,胸水合并心包积液以肺癌多见。62例恶性肿瘤患者中通过PET-CT检查明确原发灶49例,检出率为79.0%。有19例最终排除恶性肿瘤诊断,另3例未能明确诊断。以病理及临床随访诊断结果为标准,通过绘制ROC曲线SUVmax取3.6为截断值时SUVmax用于诊断多浆膜腔积液患者的可疑原发灶良恶性的准确度最高,敏感性为90.3%,特异性为81.8%,阳性预测值93.1%,阴性预测值65.2%。结论 18F-FDG PET-CT全身显像在不明原因多浆膜腔积液中有重要价值,尤其是可疑恶性肿瘤者,能在定性诊断的基础上明确定位并准确分期,指导治疗。Objective The present study was conducted to research on the value of 18F-solid glucose positron emission tomography （18 F-FDG PET）/CT whole body imaging for detection of original disease of polyserositis with unknown original disease.Methods In the retrospective analysis there were 84 patients with polyserositis,which from Jun.2006 to Jun.2013.And their PET-CT imaging data would be compared with pathology and clinical follow-up reports.Results The univariate analysis showed that in the 84 patients with polyserositis there were 42 cases with hydrothorax and ascites,30 cases with pericardial effusion and pleural effusion,6 cases with hydroperitoneum and hydropericardium,and 6 cases with pericardial effusion,hydroperitoneum and pleural effusion.The first two kinds of polyserositis were more common in clinical.Ovarian cancer,peritoneal carcinoma and lung cancer were often seen with pleural effusion ＆ ascites and lung cancer with pleural effusion ＆ pericardial effusion.Pathology and clinical follow-up results confirmed 62 cases suffered with malignancy.Of these patients,primary tumors of 49 cases were confirmed by PETCT.There were 19 cases with benign disease.And the other 3 cases of diagnosis were unknown.The accuracy for the diagnosis of patients with multiple effusion was higher when the SUVmax value was taken 3.6 through ROC curve.Conclusion 18F FDG PET-CT whole body imaging was a important tool in detection original disease of polyserositis,especially suspicious malignant tumor.In the treatment it also had a significant value.

关 键 词：正电子发射体层摄影术 脱氧葡萄糖 多浆膜腔积液 恶性肿瘤 原发灶 

分 类 号：R817.4[医药卫生—影像医学与核医学]