^18F-FDG PET/CT显像诊断不明原因腹腔积液  

^(18)F-FDG PET/CT in evaluation of ascites of undetermined origin

作　　者：张蓉琴[1,2] 尹吉林[1,2] 李向东[2] 王欣璐[2] 张金赫[2] 柳伟坤[2] 

机构地区：[1]南方医科大学第一临床医学院,广东广州510515 [2]广州军区广州总医院核医学科,广东广州510010

出　　处：《中国医学影像技术》2016年第1期79-82,共4页Chinese Journal of Medical Imaging Technology

基　　金：广东省教育部产学研结合项目(2012B091100172);广东省自然科学基金(S2012010010685)

摘　　要：目的探讨^(18)F-FDG PET/CT显像对不明原因腹腔积液患者的诊断价值。方法回顾性分析96例不明原因腹腔积液患者的PET/CT资料,将病理及临床随访结果与PET/CT进行对照。结果 96例患者中,75例为腹膜恶性肿瘤(腹膜转移瘤69例,腹膜间皮瘤4例,假黏液瘤2例);21例为良性腹膜炎(17例腹膜结核,4例细菌性腹膜炎)。PET/CT诊断腹膜良恶性病变的灵敏度、特异度和准确率分别为94.67%(71/75)、71.43%(15/21)和89.58%(86/96)。腹膜良、恶性病变的SUV_(max)分别为7.91±4.01和6.03±3.19(t=-2.25,P<0.05)。18 F-FDG代谢范围与CT病灶范围的比较对鉴别腹膜良恶性病变差异有统计学意义(χ2=35.36,P<0.01)。结论 ^(18)F-FDG PET/CT在鉴别良恶性腹腔积液方面有重要价值,尤其是对肿瘤原发灶的检出,但在诊断腹膜结核时易引起假阳性,故应当密切结合临床资料和其他检查以减少误诊。Objective To evaluate the value of ^18F-FDG PET/CT in diagnosis of ascites of undetermined origin.Methods Totally 96 patients with ascites of undetermined origin were retrospectively analyzed.The PET/CT imaging results were compared with pathology and clinical follow-up reports.Results There were 75 patients with malignant diseases including peritoneal metastasis（n=69）,peritoneal mesothelioma（n=4）and pseudomyxoma peritone（n=2）,and 21 with benign peritonitis including peritoneal tuberculosis（n=17）and bacterial peritonitis（n=4）.The sensitivity,specificity,and accuracy of PET/CT in detecting the cause of ascites were 94.67%（71/75）,71.43%（15/21）and 89.58%（86/96）,respectively.SUV_（max） was statistical significance between peritoneal benign and malignant lesions（7.91±4.01 vs 6.03±3.19;t=-2.25,P〈0.05）.There was also statistical significance to compare the scope of ^18F-FDG and CT in the diagnosis of ascites（χ2=35.36,P〈0.01）.Conclusion 18 F-FDG PET/CT offers higher value in the differential diagnosis of ascites,especially in detecting the primary tumor.In the diagnosis of peritoneal tuberculosis,^18F-FDG PET/CT can lead to a false positive,which should be closely combined with clinical data and other checks to reduce misdiagnosis.

关 键 词：腹腔积液 癌 腹膜 结核 放射性核素显像 氟脱氧葡萄糖F18 

分 类 号：R442.5[医药卫生—诊断学] R817.4[医药卫生—临床医学]