贲门癌术后吻合口复发^(18)F-FDGPET/CT显像与形态分析  

^(18)F-FDG PET/CT imaging and morphological characteristics of postoperative recurrence of cardia cancinoma at anastomotic stoma

作　　者：夏兆云[1] 徐荣泰[1] 沈乐[1] 

机构地区：[1]武警江苏总队医院医学影像科,扬州225003

出　　处：《武警医学》2017年第8期809-811,815,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨贲门癌术后吻合口复发18F-FDG PET/CT显像效果与形态特点。方法收集武警江苏总队医院内镜、外科手术及病理证实贲门癌术后吻合口复发52例患者PET/CT、CT影像资料,对照分析贲门癌手术后复发患者PET/CT及CT影像表现。结果 (1)52例贲门癌术后复发18F-FDGPET/CT显像无摄取3例(5.77%,3/52),有摄取49例(94.23%,49/52),其中片絮状摄取14例(26.92%,14/52),结节状摄取19例(36.54%,19/52,),环状摄取16例(30.77%,16/52,);(2)CT显示吻合口管壁无明显增厚4例(7.69%,4/52),轻度增厚7例(13.46%,7/52),偏心性增厚19例(36.54%,19/52),环状增厚22例(42.31%,22/52);PET/CT与CT两者形态分类上显著相关(r=0.943,P<0.001)。(3)18F-FDG PET/CT显像片絮状摄取半定量标准值(SUVmax均数、SUVmean均数)与其他摄取形态及总体摄取值比较相对较低,且具有统计学差异(P<0.01)。(4)PET/CT显像明确及疑似诊断贲门癌术后复发45例(86.54%,45/52),未能作出复发诊断7例(13.46%,7/52);CT诊断及疑似诊断贲门癌术后复发41例(78.85%,41/52),未能作出复发诊断11例(21.15%,11/52),诊断结果两者无明显差异(χ2=13.48,P=0.063);PET/CT摄取分型中无摄取、片絮状摄取诊断结果与结节状摄取、环状摄取诊断结果存在一定差异(χ2=27.25,P=0.017,P<0.05)。(5)PET/CT不能明确诊断术后复发无摄取3例及片絮状摄取4例;CT不能明确诊断术后复发为吻合口无明显增厚4例及轻度增厚7例患者。结论贲门癌术后吻合口复发18F-FDG PET/CT无摄取及片絮状摄取是诊断中的难点,在实际工作中结合CT吻合口厚度及其形态,对提高贲门癌术后吻合口复发18F-FDG PET/CT诊断符合率有一定帮助。Objective To explore the relationships between （18）F-FDG PET/CT imaging and morphology of postoperative recurrence of cardia cancinoma at the anastomotic stoma. Methods PET/CT and CT imaging data of fifty-two patients with postoperative recurrence,who had been confirmed by endoscopy,surgery and pathological examination,was collected and compared. Results Among the fifty-two patients,^（18）F-FDG PET/CT imaging found no uptake in 3 cases（ 5. 77%,3/52）,but found uptake in the other 49 cases（ 94. 23%,49/52）. Among these 49 cases,there was patchy uptake in 14 cases（ 26. 92%,14/52）,nodular uptake in 19 cases（ 36. 54%,19/52）,and annular uptake in 16 cases（ 30. 77%,16/52. CT imaging showed no obvious anastomotic wall thickening in 4 cases（ 7. 69%,4/52）,but mild thickening in 7 cases（ 13. 46%,7/52）,eccentric thickening in 19 cases（ 36. 54%,19/52）,and annular thickening in 22cases（ 42. 31%,22/52）. There were significant correlations between PET/CT and CT in morphological classification（ r = 0. 943,P〈0. 001）. The semi-quantitative standardized uptake value（ SUVmax、SUVmean） of patchy uptake on ^（18）F-FDGPET/CT imaging was relatively lower than that of morphological and overall uptake,and there was significant difference between them（ P〈0. 01）. There was no significant difference between PET/CT and CT imaging in the accuracy rate of clear or suspicious diagnosis or in the rate of failure to diagnose postoperative recurrence（ 86. 54%,45/52 versus 78. 85%,41/52; 13. 46%,7/52 versus 21. 15%,11/52,χ2= 13. 48,P = 0. 063）,but there was difference in diagnosis between no uptake,patchy uptake and nodular uptake,annular uptake in PET/CT imaging（ χ2= 27. 25,P = 0. 017,P〈0. 05）. PET/CT imaging failed to diagnose postoperative recurrence in 3 cases of no uptake and 4 cases of patchy uptake,compared to 4 cases of no obvious anastomotic wall thickening and 7 cases of mild thickening by CT imanging. Conclusions Postoperative recurrence of cardia cancinoma at the anas

关 键 词：贲门癌 吻合口 复发癌 正电子发射体层扫描 X线计算机断层扫描 氟18-脱氧葡萄糖 

分 类 号：R735.2[医药卫生—肿瘤] R573[医药卫生—临床医学]