^(18)F-FDG PET/CT显像对胃肠肿瘤术后肠梗阻病因学的诊断价值  

Clinical Significance of ^(18)F-FDG PET/CT in the Etiological Diagnosis of Postoperative Intestinal Obstruction in Patients with Gastrointestinal Cancer

作　　者：李雪娜[1] 李娜[1] 杜补林[1] 李亚明[1] 

机构地区：[1]中国医科大学附属第一医院核医学科,沈阳110001

出　　处：《中国医科大学学报》2016年第5期422-425,共4页Journal of China Medical University

基　　金：国家自然科学基金(81301249);辽宁省科学技术计划(2012225013)

摘　　要：目的探讨氟-代脱氧葡萄糖正电子发射型断层显像(^(18)F-FDG PET/CT)显像对胃肠肿瘤术后肠梗阻病因学的诊断价值。方法胃肠肿瘤术后不明原因肠梗阻行^(18)F-FDG PET/CT显像的患者51例,图像分析采用视觉定性和通过半定量分析测量病变最大标准摄取值(SUV_(max))。所有患者经手术病理学诊断或临床≥6个月以上的随访。计算^(18)F-FDG PET/CT显像诊断胃肠肿瘤术后肠梗阻病因的敏感度、特异度和准确性。结果 51例患者中,35例患者最终诊断为恶性肿瘤复发性肠梗阻,16例为非复发性肠梗阻。^(18)F-FDG PET/CT显像阳性36例,其中33例患者最终诊断为恶性肿瘤复发性肠梗阻,3例显像假阳性为腹膜炎粘连性肠梗阻、吻合口炎症。2例^(18)F-FDG PET/CT显像假阴性为腹膜微浸润。恶性肿瘤复发性肠梗阻病变的SUV_(max)为8.86±4.82,非复发性肠梗阻病变的SUV_(max)为2.05±1.95,两者差异有统计学意义(t=7.15,P<0.01)。^(18)F-FDG PET显像诊断恶性肿瘤复发性肠梗阻的敏感度为94.3%,特异度为81.3%,准确性为90.2%。结论恶性肿瘤复发性肠梗阻的^(18)F-FDG摄取率明显高于非复发性肠梗阻,^(18)F-FDG PET/CT显像对肠梗阻病因学有很好的诊断价值。Objective To explore the significance of 18fluorodeoxyglucose positron emission tomography （18F-FDG PET/CT） in the etiological diag- nosis of postoperative intestinal obstruction in patients with gastrointestinal cancer. Methods A total of 51 patients with postoperative intestinal ob- struction undergone 18F-FDG PET/CT were enrolled for the study. The images were interpreted by visual and semi-quantitative analysis （ maximum standard uptake value, SUVmax）. All the cases were confirmed by pathology and clinical follow-up for more than half a year. The sensitivity, specifici- ty and accuracy of 18F-FDG PET/CT for detecting malignant intestinal obstruction were calculated. Results Of the 51 patients, 35 cases were con- firmed for malignant intestinal obstruction, and 16 cases were caused by other benign diseases. 18F-FDG PET/CT imaging was positive in 36 cases, and 33 cases were diagnosed as malignant and recurrent intestinal obstruction. Three cases of PET false-positive were peritonitis adhesion and anasto- motie inflammation. Two cases of PET false negative were peritoneal mierometastasis. The SUVmax of malignant lesions was 8.86±4.82, and the SUVmax of benign lesions was 2.05± 1.95. The uptake of FDG was significantly higher in malignant intestinal obstruction than in benign intestinal obstruction （ t = 7.15, P 〈 0.01 ）. The sensitivity, specificity, and aecttmey of 18F-FDG PET/CT diagnosis of malignant lesion were 94.3%, 81.3%, and 90.2%, respectively. Conclusion The uptake of 18F-FDG in malignant intestinal obstruction was higher than that in benign intestinal obstruction. 18F-FDG PET/CT have a good diagnostic value for the intestinal obstruction of postoperative gastrointestinal cancer.

关 键 词：肠梗阻 正电子发射断层显像术 X线计算机体层摄影术 

分 类 号：R445.5[医药卫生—影像医学与核医学]