贲门癌术后吻合口复发^(18)F-FDG PET/CT显像与病理对照  

^(18)F-FDG PET/CT imaging and pathological findings of postoperative recurrence of cardia carcinoma at anastomotic stoma:Comparison analysis

作　　者：夏兆云[1] 徐荣泰[1] 沈乐[1] 

机构地区：[1]武警江苏省总队医院医学影像科,江苏扬州225003

出　　处：《中国介入影像与治疗学》2014年第8期528-531,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的探讨贲门癌术后吻合口肿瘤复发18 F-FDG PET/CT表现和半定量标准摄取值(SUV)与病理结果的关系。方法收集78例贲门癌术后吻合口复发患者的PET/CT和病理资料,对照分析PET/CT表现、SUV与病理结果。结果 178例中,中低分化腺癌59例(59/78,75.64%),未分化腺癌4例(4/78,5.13%),高分化腺癌7例(7/78,8.97%),黏液腺癌5例(5/78,6.41%),印戒细胞癌2例(2/78,2.56%),鳞腺癌1例(1/78,1.28%);2PET/CT表现为无摄取5例(5/78,6.41%)、片絮状摄取15例(15/78,19.23%),结节(团块)状摄取33例(33/78,42.31%),环状摄取25例(25/78,32.05%);3吻合口复发SUVmax为4.04±2.06,与其他组织类型比较,中低分化腺癌、未分化腺癌SUVmax较高(P<0.05),且多以结节状、环状显像形态为主;4PET/CT诊断正确71例(71/78,91.03%)。结论贲门癌术后吻合口复发PET/CT显像表现形式多样,以结节状、环状摄取为主;分化腺癌、黏液腺癌及印戒细胞癌或PET/CT显像表现为无摄取及片絮状低摄取者易漏诊。Objective To explore the relationship between 18F_FDG PET/CT imaging manifestations, semi-quantitative standardized uptake value （SUV） and pathotogical findings of postoperative recurrence of eardia carcinoma at the anasto- motic stoma. Methods PET/CT imaging and pathological data of 78 patients with postoperative anastomotic stoma recur- rence of cardia carcinoma were collected, and the PET/CT performances, semi-quantitative SUVs and pathological results were analyzed, respectively. Results ①Among all 78 patients, there were 56 cases of moderate-low differentiated adeno- carcinomas （59/78, 75.64 %）, 4 undifferentiated adenocarcinomas （4/78, 5.13 %）, 7 high differentiated adenocarcinomas （7/78, 8.97%）, 5 mueinous adenocarcinomas （5/78, 6.41%）, 2 signet-ring cell carcinomas （2/78, 2.56%） and 1 adeno- squamous carcinoma （1/78, 1.28%）. ②PET/CT imaging found no uptake in 5 cases （5/78, 6.41%）, patchy shadows uptake in 15 （15/78, 19.23%）, nodular uptake in 33 （33/78, 42.31%）, while annular uptake in 25 cases （25/78, 32.05 %）. ③The overall SUVmaxOf recurrence of cardia carcinoma was 4.04 4-2.06. SUVmaxof moderate-low differentiated adenocarcinoma and undifferentiated adenocarcinoma was relatively higher than that of other pathological types of cardia carcinoma （P〈0.05）, both of them mainly manifested as nodular and annular form on PET/CT. ④The diagnostic accura- cy rate of PET/CT for cardia carcinoma at the anastomotic stoma was 91.03% （71/78）. Conclusion Postoperative recur- rence of cardia carcinoma at the anastomotic stoma has various PET/CT performances, mainly display as nodular and annu- lar uptake. High differentiated adenocarcinoma, mutinous adenocarcinoma and signet-ring cell carcinoma or tumors without uptake on PET/ CT imaging or presenting as patchy shadows uptake are easy to be misdiagnosed.

关 键 词：贲门 胃肿瘤 肿瘤复发 局部 正电子发射体层扫描 氟脱氧葡萄糖F18 病理学 

分 类 号：R735.2[医药卫生—肿瘤] R814.7[医药卫生—临床医学]