增强MRI和PET/CT在腹膜假性黏液瘤诊断及良恶性鉴别中的应用价值  

Enhanced MRI and PET/CT in the diagnosis of benign and malignant peritoneal pseudomyxoma and discriminant value

作　　者：李冠[1] 邹明宇[1] 杨本强[1] 王治国[2] 林森[1] 张立波[1] 谢磊[1] 

机构地区：[1]解放军沈阳军区总医院放射诊断科,110016 [2]解放军沈阳军区总医院核医学科,110016

出　　处：《中国临床实用医学》2017年第2期20-25,共6页China Clinical Practical Medicine

基　　金：辽宁省自然科学基金项目（2014020066）

摘　　要：目的 探讨增强MRI及PET/CT对腹膜假性黏液瘤（PMP）的诊断价值及良恶性鉴别的灵敏度及特异度.方法 回顾性分析2011年1月至2016年6月解放军沈阳军区总医院收治的疑似诊断为PMP的46例患者的临床资料.所有患者术前均行增强MRI及PET/CT检查,以术后病理或临床综合评价诊断为标准,比较两种检查方法在PMP诊断及良恶性鉴别中的价值.结果 46例患者中确诊为PMP者34例,非PMP者12例.增强MRI及PET/CT检查对PMP诊断的灵敏度分别为72.0%、93.7%,两者差异有统计学意义（P〈0.05）.在腹腔淋巴结转移判断方面,增强MRI和PET/CT的灵敏度分别为40.9%、85.6%,两者差异有统计学意义（P〈0.001）;在肝、脾转移判断方面,增强MRI和PET/CT的灵敏度分别为50.2%、78.9%,两者差异无统计学意义（P=0.68）;在腹水良恶性判断方面,PET/CT具有较高的灵敏度,两者差异有统计学意义（P〈0.05）.结论 PET/CT对PMP诊断有较高的灵敏度,优于增强MRI,且PET/CT有助于发现淋巴结、肝、脾转移情况,并可通过对腹水18 F-FDG摄取的多少,间接判断PMP的良恶性,利于指导临床病理分型,为早期确立准确的治疗方案提供参考依据.Objective To investigate enhanced MRI and PET/CT value in the diagnosis pseud-omyxoma peritonei（ PMP） and distinguishing benign and malignant. Methods A retrospective study was performed on 46 PMP patients who were admitted from January 2011 to June 2016. All the patients received preoperative enhanced MRI scans and PET/CT. The diagnosis of postoperative pathological or clinical com-prehensive evaluation was standard. To compare the value of the two methods in the diagnosis of PMP′s be-nign or malignant. Results Among 46 patients, 34 cases were diagnosed with PMP and 12 cases were non PMP. The sensitivity of enhanced MRI and PET/CT examination for PMP diagnosis were 72. 0% and 93. 7%, respectively（P〈0. 05）. The sensitivity of enhanced MRI and PET/CT examination in diagnosis of abdominal lymph node metastasis were 40. 9% and 85. 6%, respectively（P〈0. 001）;the sensitivity of en-hanced MRI and PET/CT examination in the judgment of liver and spleen metastasis were 50. 2% and 78. 9%, respectively, with no statistical significance （ P =0. 68 ）;the sensitivity of enhanced MRI and PET/CT examination in diagnosis of benign or malignant ascites, PET/CT had a higher sensitivity and bet-ter than enhanced MRI（P〈0. 05）. Conclusion PET/CT in the diagnosis of PMP has a higher sensitivity than enhanced MRI, and PET/CT could help to find lymph nodes, liver and spleen metastasis, through ^18 F-FDG uptake in ascites, indirectly diagnosis of PMP′s benign or malignant, guide the clinical pathologi-cal type and provide early accurate treatment plan.

关 键 词：腹膜假性黏液瘤 增强MRI PET/CT 腹水 

分 类 号：R735[医药卫生—肿瘤] R730[医药卫生—临床医学]