18^氟-氟代脱氧葡萄糖正电子发射断层／计算机辅助断层检查在葡萄膜黑色素瘤诊断应用中的初步探讨  

Preliminary study on the application of 18-Fluorine-labelled 2-deoxy-2-fluoro-D-glucose positron emission tomography/computed tomography in uveal melanoma

作　　者：张蕾[1] 宋国祥[2] 李祖贵[3] 何彦津[4] 张虹[2] 赵红[1] 

机构地区：[1]天津市眼科医院天津市眼科学与视觉科学重点实验室天津市眼科研究所天津医科大学眼科临床学院,300020 [2]天津医科大学第二医院眼科 [3]武警后勤学院附属医院核医学科 [4]天津医科大学眼科医院

出　　处：《中华眼底病杂志》2015年第5期451-454,共4页Chinese Journal of Ocular Fundus Diseases

摘　　要：目的初步探讨”氟一氟代脱氧葡萄糖（18^F—FDG）正电子发射断层（PET）／计算机辅助断层（CT）检查在葡萄膜黑色素瘤诊断中的应用价值。方法经眼球摘除组织病理学或影像学检查确诊为葡萄膜黑色素瘤的23例患者纳入研究。其中，男性16例，女性7例；平均年龄（49．8±12．3）岁。均为单眼，右眼11只，左眼12只。经眼球摘除病理组织证实诊断15例，经荧光素眼底血管造影、眼部B型超声及核磁共振成像等影像学诊断8例。经眼球摘除组织病理学证实诊断的15例患者中，混合细胞型7例，梭形细胞型6例，上皮细胞型2例。以混合细胞型与上皮样细胞型为影响预后因素的高危型，梭形细胞型为低危型。所有患者均行18^F-FDGPET／CT检查，计算标准摄取值（SUV）。以最大SUV（SUVmax）≥2．5为恶性肿瘤的诊断标准。CT观察肿瘤形状、位置，并测量肿瘤基底最大径及隆起高度。Spearman等级相关检验分析SUVmax与肿瘤基底最大径、隆起高度的相关性。对比分析18^F-FDGPET／CT对影响预后因素的高危型和低危型患者的检出率。结果所有患者CT像均见眼内异常高密度影。其中，半球形8例，扁平形7例，蘑菇形4例，类圆形3例，弥漫形1例。肿瘤位于后极部9例，颞侧赤道部5例，鼻侧赤道部4例，上方赤道部、颞侧睫状体、下方睫状体、颞侧虹膜、鼻侧虹膜睫状体各1例。患者SUVmax为1．1～7．8。其中，SUVmax≥2．5者9例，占39．13％；SUVmax〈2．5者14例，占60．87％。SUVmax≥2．5的9例患者，平均肿瘤基底最大径（17．53±3．48）mm，平均肿瘤隆起高度（11．37士3．85）mm。SUVmax〈2．5的14例患者，平均肿瘤基底最大径（10．66±3．25）mm，平均肿瘤隆起高度（5．33±2．23）mm。SUVmax≥2．5者平均肿瘤基底最大径及平均隆起高度均大于SUVmax〈2．5者，差异有统计学意义（t=4．815、4．786，P〈0Objective To assess the use of 18-Fluorine-labelled 2-deoxy-2-fluoro-D-glucose positron emission tomography/computed tomography （18 F-FDG PET/CT） in the diagnosis of uveal melanoma. Methods Twenty-three patients with uveal melanoma confirmed by histopathologic examination or imaging examination were enrolled. There were 16 male, 7 female, and the mean age was （49.8±12.3） years. Allthe lesions were unilateral, with 11 cases in OD, 12 cases in OS. Diagnosis was confirmed by histopathological examination of enucleated eyeballs in 15 cases, by ophthalmoscope, fundus fluorescein angiography, ocular B-mode ultrasound and magnetic resonance imaging and other imaging technology in 8 cases. 15 patients diagnosed by histopathologic examination of enucleated eyeballs were divided into three types including mixed （7 patients）, spindle cell （6 patients） and epithelioid cell （2 patients） types. The mixed cell type and epithelioid cell type are considered as high-risk; spindle cell type is low-risk. All the patients were evaluated by whole body PET/CT. The location, size, shape, boundary of the lesions, and the relationship with adjacent structures were observed in CT images. 18F-FDG uptake was quantitative expression by standardized uptake value （SUV） in PET image; positive diagnosis should be made when the maximum standardized uptake value （SUVmax） was not less than 2.5. The correlation between SUVmax and maximum diameter of tumor base, tumor height was analyzed by Spearman rank correlation test. The detection rate of high-risk and low-risk patients between 18 F-FDG PET and CT methods was comparative analyzed. Results All the CT images showed abnormal high density ocular lesions. The shape of the lesions included 8 patients of semi sphere-like, 7 patients of flat-like, 4 patients of mushroom-like, 3 patients of round-like and 1 patient of diffuse lesions. The tumors were located in the posterior pole （9 patients）, temporal equator （5 patients）, nasal equator （4 patients）, superior equa

关 键 词：葡萄膜肿瘤/诊断 正电子发射断层显像术 氟放射性同位素/诊断应用 体层摄影术 X线计算机 

分 类 号：R739.72[医药卫生—肿瘤]