^(18)F-FDGPET/CT在皮革胃与胃充盈不良鉴别诊断中的应用价值  

Application value of ^(18)F- FDG PET/CT in differential diagnosis of linitis plastica and normal gastric cavity with poorly water filling

作　　者：程兵[1] 谢新立[1] 韩星敏[1] 刘保平[1] 韩军[1] 

机构地区：[1]郑州大学第一附属医院核医学科,河南郑州450052

出　　处：《河南医学研究》2015年第8期19-22,共4页Henan Medical Research

摘　　要：目的研究皮革胃的18F-FDG PET/CT图像特点,探讨18F-FDG PET/CT在皮革胃与胃充盈不良鉴别诊断中的应用价值。方法回顾性分析18例经病理证实的皮革胃患者的18F-FDG PET/CT图像特征,统计胃壁SUVmax,并与46例胃充盈不良的体检者进行比较。结果 18例皮革胃患者中,有12例胃FDG摄取不高或仅有轻度摄取。PET/CT能明确诊断胃癌者仅9例,误诊为生理性摄取者2例,7例结果不能与生理性摄取或炎症鉴别。皮革胃与胃充盈不良者两组间补充饮水前SUVmax差异无统计学意义(Z=-0.829,P=0.407);补充饮水后皮革胃组SUVmax变化不明显,而胃充盈不良者胃壁FDG摄取减低,两组间SUVmax差异有统计学意义(Z=-5.126,P=0.001)。结论18F-FDG PET/CT检查对皮革胃FDG的摄取与胃充盈不良时胃壁的FDG生理性摄取鉴别困难,补充饮水是鉴别两者的简单方法。对CT怀疑胃壁增厚患者,建议补充饮水后再次进行18F-FDG PET/CT检查,以避免漏诊。Objective To clarify the characteristics of fluorine - 18 fluorodeoxyglucose positron emission tomography/ compu-ted tomography（18 F - FDG PET/ CT）findings of linitis plastica,and explore the application value of 18 F - FDG PET/ CT in dif-ferential diagnosis of linitis plastica and normal gastric cavity with poorly water filling. Methods The characteristics of ^18 F -FDG PET/ CT findings in 18 patients with linitis plastica confirmed by pathology. The standardized uptake value - maximum （SUVmax）of the gastric wall was calculated and compared with 46 cases of normal gastric cavity with poorly water filling. Results Among the 18 cases of linitis plastica,12 cases showed low to moderate level of ^18 F - FDG uptake. 9 cases of linitis plas-tica were confirmed by PET/ CT and 2 cases were misdiagnosed as physiological uptake. Other 7 cases could not be differentiated from physiological uptake or inflammatory. There was no significant difference in SUVmax before water intake between linitis plastica and normal gastric cavity（Z = - 0. 829,P = 0. 407）. After water intake,the change of SUVmax in linitis plastica group was not obvious,and the FDG intake of gastric wall in patients with normal gastric cavity with poorly water filling was significantly de-creased（ Z = - 5. 126,P = 0. 001）. Conclusion ^18 F - FDG PET/ CT could not effectively distinguish physiological uptake of poorly gastric filling from linitis plastica. Water intake may be useful to prevent misdiagnosis. The diagnostic value of this tech-nique based on SUVmax is limited. For patients with gastric wall thickening diagnosed by CT,^18 F - FDG PET/ CT examination after water intake may be the good choice to advoid missed diagnosis.

关 键 词：胃肿瘤 皮革胃 计算机断层扫描 正电子发射型计算机断层显像 ^18F-FDG 

分 类 号：R735.2[医药卫生—肿瘤]