利尿后18 F-FDG PET／CT延迟显像探测男性直肠癌局部复发的临床价值  

Clinical value of delayed 18 F-FDG PET/CT imaging after diuresis in male patients with locally re-current rectal cancer

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6期446-450,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：甘肃省卫生行业科研计划项目（GSWST2013-01）

摘　　要：目的：评价利尿后18 F-FDG PET／CT盆腔延迟显像探测男性直肠癌局部复发的临床价值。方法回顾性分析临床疑似复发的32例（年龄32～79岁）男性直肠癌患者资料。所有患者均先完成18 F-FDG PET／CT常规显像，然后予以静脉注射呋塞米20 mg利尿，配合饮水，于注射18 F-FDG后2．5 h左右行盆腔延迟显像。依据病理或随访（＞10个月）结果，比较PET／CT常规与延迟显像的诊断效能。采用χ2检验分析数据。结果32例患者中，25例局部复发，其中10例合并直肠邻近组织器官受侵，5例合并远处转移；7例局部无复发，但其中2例合并远处转移。常规显像的诊断灵敏度、特异性、准确性分别为92．0％（23／25）、3／7、81．2％（26／32）；延迟显像中，所有患者膀胱放射性分布达到或接近本底，灵敏度、特异性、准确性分别为96．0％（24／25）、6／7、93．8％（30／32）。常规与延迟显像的灵敏度、准确性差异无统计学意义（χ2＝0．085和0．966，均P＞0．05），特异性后者高于前者（χ2＝14．333，P＜0．05）。直肠邻近组织器官受侵病灶共计22处，延迟显像的阳性率高于常规显像[95．5％（21／22）和63．6％（14／22）；χ2＝6．400，P＜0．05]。结论利尿后18F-FDG PET／CT延迟显像能消除膀胱尿液的放射性伪影，可更有效检出直肠邻近组织器官受侵病灶，从而弥补常规显像探测男性直肠癌局部复发的不足。Objective To explore the diagnostic value of delayed 18 F-FDG PET/CT pelvic imaging after forced diuresis in detecting male patients with locally recurrent rectal cancer. Methods Thirty-two male patients （ 32-79 years） with clinically suspicious recurrences of rectal cancer were retrospectively ana-lyzed. All patients underwent a standard 18 F-FDG PET/CT followed by a delayed pelvic imaging after 2.5 h of administration of 20 mg furosemide intravenously and extra water intake of 500 ml at least. Final diagnosis was made by pathology or clinical follow-up （〉10 months ） . Diagnostic efficiency of 18 F-FDG PET/CT standard and delayed pelvic images were calculated and compared. χ2 test was used for data analysis. Re-sults A total of 25 patients were diagnosed with recurrent rectal cancer, including 10 cases with invasion of surrounding tissue, and 5 cases with metastases. Among the 7 patients without local recurrences, 2 had dis-tant metastases. The sensitivity, specificity, and accuracy of standard FDG PET/CT were 92.0%（23/25）, 3/7, 81.2%（26/32）, respectively. The corresponding values of the delayed imaging were 96.0%（24/25）, 6/7, and 93.8%（30/32）, respectively. The specificity of delayed imaging was higher than that of standard FDG PET/CT （χ2=14.333, P〈0.05） , but no significant differences were found in sensitivity and accuracy between the delalyed imaging and standard FDG PET/CT （χ2=0.085 and 0.966, both P〉0.05） . The urina-ry bladder activity reached or approached the background during the delayed imaging. Twenty-two malignant lesions of surrounding invasion were confirmed. The positive rate of delayed imaging was higher than that of standard FDG PET/CT：95.5%（21/22） vs 63.6%（14/22）;χ2=6.400, P〈0.05. Conclusions 18F-FDG＆amp;nbsp;PET/CT delayed pelvic imaging after diuresis and hydration is useful for eliminating the artifacts from urina-ry bladder activity, and for detecting the invasion to the rectal surrounding tissue more effectively. It could be a supple

关 键 词：直肠肿瘤 肿瘤复发 局部 利尿 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：R735.37[医药卫生—肿瘤] R730.44[医药卫生—临床医学]