^(18)F-FDG PET/CT在宫颈癌初诊患者中的临床应用价值  

Clinical Application of ^(18)F-FDG PET /CT in Diagnosing Cervical Cancer at Patient's First Visit

作　　者：孙倩[1,2] 陈文波[3] 刘恩涛[2] 王秋实[3] 王淑侠[2] 

机构地区：[1]南方医科大学,广州510515 [2]广东省医学科学院广东省人民医院伟伦PET中心,广州510080 [3]广东省医学科学院广东省人民医院放射科,广州510080

出　　处：《临床放射学杂志》2014年第9期1381-1385,共5页Journal of Clinical Radiology

摘　　要：目的探讨18F-FDG PET/CT显像在宫颈癌初诊患者中的应用价值。方法回顾性分析43例经病理学证实的FIGO分期ⅠB期及以上的宫颈癌患者的临床资料和治疗前10天内18F-FDG PET/CT及同机增强CT的影像资料。结果 PET/CT与同机增强CT诊断宫颈癌原发灶的灵敏度分别为100%、86.0%,差异有统计学意义(χ2=4.479,P=0.034)。分别以患者和淋巴结分区为单位计算,18例患者伴区域淋巴结转移,36例手术患者共切除的351组区域淋巴结中,病理学证实存在27组转移淋巴结,PET/CT灵敏度均为77.8%,同机增强CT的灵敏度为63.2%,48.1%。以淋巴结分区为单位计时,两者灵敏度差异有统计学意义(χ2=5.082,P=0.024)。43.5%患者依据PET/CT影像资料更改了临床治疗方案,其中3例发现远处转移灶。结论18F-FDG PET/CT不但可准确判断宫颈癌原发灶的侵犯范围,而且可以检出淋巴结及远处器官转移,在宫颈癌诊断及指导临床治疗决策等方面均有重要的应用价值。Objective To assess the clinical value of 18F-FDG PET/CT in diagnosing cervical cancer at patient＇ s first visit. Methods A total of 43 patients with pathologically-proved cervical cancer （ FIGO stage I B - Ⅳ ） were enrolled in this study. 18F-FDG PET/CT and contrast-enhanced CT scanning （using the same scanner） were performed within 10 days before treatment. The clinical data and the imaging materials were retrospectively analyzed. The sensitivities of 18F-FDG PET/CT and contrast-enhanced CT in diagnosing primary cancer, lymph node metastasis and distant metastasis were deter- mined. The results were compared between the two techniques. Results The sensitivities of 18F-FDG PET/CT and en- hanced contrast CT scan for the diagnosis of cervical cancer were 100% and 86.0% respectively, the difference was statis- tically significant （X2 = 4.479,P = 0. 034）. Regional lymph node metastasis was detected in 18 patients. A total of 351 groups of regional lymph nodes were excised in 36 patients, among which lymph node metastasis was found in 27. The sen- sitivities of 18F-FDG PET/CT and enhanced contrast CT in detecting lymph node metastasis were 77.8 % and 53.2% re- spectively. Significant difference in the sensitivity of regional lymph node metastasis existed between 1SF-FDG PET/CT and enhanced contrast CT （ X2 = 5. 082,P = 0.024）. After PET/CT findings were taken into consideration, 43.5 % （20/43） of the patients had to change their treatment plans, and distant metastases were demonstrated in 3 patients. Conclusion 18F- FDG PET/CT not only can precisely determine the extent of primary cervical cancer, but also can detect lymph node metas- tasis as well as distant metastases, which are very helpful in making the diagnosis and in guiding clinical treatment.

关 键 词：宫颈癌 诊断 正电子发射断层成像/计算机体层摄影术 18F氟脱氧葡萄糖 

分 类 号：R737.33[医药卫生—肿瘤]