18F-FDG PET/CT利尿延迟显像对膀胱肿瘤的诊断价值  

Diagnostic value of 18F-FDG PET/CT delayed imaging after diuresis in patients with primary bladder tumor

作　　者：王慧春[1] 陈晓红[1] 崔兰兰[1] 王亚群[1] 冯维贵[1] 庞燕[1] 王玉斌[1] 

机构地区：[1]甘肃省人民医院PET/CT中心,兰州730000

出　　处：《中华核医学与分子影像杂志》2015年第1期10-13,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的 评价18F-FDG PET/CT利尿延迟显像对膀胱肿瘤的诊断价值.方法 回顾性分析14例经手术病理证实的膀胱肿瘤（临床分期T1～3N0M0）患者（男12例,女2例,年龄35 ～ 88岁）,患者均先完成18F-FDG PET/CT常规显像,之后随即静脉注射呋塞米20 mg,同时充分饮水水化,注射FDG后2.5～ 3.0 h行盆腔延迟显像.将膀胱病灶放射性聚集高于尿液设定为高摄取（阳性）,等于或小于尿液放射性为等或低摄取（阴性）.将PET/CT表现与病理结果进行对照分析.采用Mann-Whitney u检验分析数据.结果 14例肿瘤中恶性12例[包括尿路上皮癌11例,鳞状细胞癌（简称鳞癌）1例],良性2例（均为乳头状瘤）.12例恶性中,3例PET/CT常规显像呈阳性表现,9例假阴性;2例良性肿瘤PET/CT常规显像均阴性;诊断灵敏度、特异性、准确性分别为3/12、2/2和5/14.3例真阳性病灶直径大于9例假阴性的直径[26、30、35 mm和（15.6±6.3） mm;Z=-2.315,P＜0.05].延迟显像的诊断灵敏度、特异性、准确性分别为11/12、2/2和13/14.结论 18F-FDG PET/CT利尿延迟显像有助于对膀胱肿瘤良恶性的鉴别诊断.Objective To explore the diagnostic value of 18F-FDG PET/CT delayed imaging after induced diuresis for primary bladder tumor.Methods Fourteen patients （12 males,2 females; age range 35-88 years） with pathologically confirmed primary bladder tumor （clinical stage T1.3N0M0） were retrospectively analyzed.All patients underwent standard 18F-FDG PET/CT followed by a delayed （2.5-3.0 h later）pelvic imaging post intravenous injection of 20 mg furosemide and oral intake of 600 ml water.A ＆quot;positive＆quot;lesion was defined as the uptake of 18F-FDG greater than the urine radioactivity and ＆quot;negative＆quot; as equaled to or less than the urine radioactivity.Diagnostic efficacy of 18F-FDG PET/CT was calculated with pathology as the gold standard.Mann-Whitney u test was used to analyze data.Results There were 12 malignant （11 urothelium carcinomas and 1 squamous cell carcinoma） and 2 benign tumors （papillary epitheliomas）.On standard PET/CT imaging,3 of 12 malignant lesions showed increased metabolism of 18F-FDG and the other 9 were false negative; while the 2 benign tumors showed no abnormal 18F-FDG uptake.The sensitivity,specificity,and accuracy of 18F-FDG PET/CT were 3/12,2/2 and 5/14,respectively.Sizes of the 3 18F-FDG-avid malignant lesions were greater than those of other 9 18F-FDG-negative lesions （26,30,35 mm vs （15.6±6.3） mm; Z=-2.315,P〈0.05）.The sensitivity,specificity,and accuracy of delayed pelvic imaging were 11/12,2/2,13/14,respectively.Conclusion 18F-FDG PET/CT delayed imaging after diuresis has a high diagnostic efficacy for primary bladder tumor.

关 键 词：膀胱肿瘤 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：R737.14[医药卫生—肿瘤] R730.44[医药卫生—临床医学]