多模态影像检查在小细胞肺癌诊断与疗效评估中的应用  

Application of multimodality imaging in the diagnosis and therapeutic evaluation of small cell lung cancer

作　　者：颜有霞[1] 肖立志[2] 谭延林[2] 王云华[2] 

机构地区：[1]青海省人民医院PET/CT中心,青海西宁810007 [2]中南大学湘雅二医院PET/CT中心,湖南长沙410000

出　　处：《医学影像学杂志》2017年第11期2106-2109,共4页Journal of Medical Imaging

摘　　要：目的探讨18F-FDG PET/CT及CT增强、CT肺部高分辨扫描多模态影像检查在小细胞肺癌诊断与疗效评估中的应用价值。方法回顾性分析2013年10月~2016年11月行全身18F-FDG PET/CT检查,并经病理证实为小细胞肺癌的28例患者(男23例,女5例,年龄42~78岁)的多模态影像资料、TNM分期。以原发灶SUVmax值10为界分为两组,两周期化疗后复查PET/CT,比较化疗前后原发灶大小、SUVmax、TNM分期的变化。治疗前后的SUVmax的变化率用t检验分析。结果 28例小细胞肺癌CT增强扫描以轻中度强化为主,强化多不均匀;PET/CT原发灶SUVmax>10的16例,SUVmax≤10的12例,经两个周期化疗后,与SUVmax>10组比较,SUVmax≤10组患者原发灶明显变小、SUVmax显著降低、转移灶明显减少;两组患者治疗前后SUVmax的变化率经t检验,结果有显著差异(P<0.05),表明SUVmax≤10组对化疗更加敏感。结论多模态影像检查对SCLC的定性诊断、精确分期、疗效判定以及预后评估有重要价值,SUVmax可作为预测SCLC化疗预后的参数。Objective To investigate the value of muhimodality imagings including ^18F-FDG PET/CT, pulmonary enhanced CT and high resolution CT scanning in the diagnosis and therapeutic evaluation of the small cell lung cancer （SCLC）. Methods From October 2013 to November 2016, 28 patients （23 males, 5 females, from 42 -78 years old） who underwent 18 F-FDG PET/ CT and were diagnosed with SCLC by pathological examination were retrospectively studied. Multimodality image data were col- lected and TNM staging was carried out. All patients were divided into two groups with the SUVmax of 10 in the primary lension as the dividing point. Followed-up JSF-FDG PET/CT was performed for each patient after two cycles of chemotherapy. The chan- ges of the size of primary tumor, SUVmax and TNM staging before and after chemotherapy were compared. The rate of SUVmax change in these two groups was compared using t test analysis before and after treatment. Results The pulmonary enhanced CT in all 28 eases has the feature of moderate and uneven enhancement. Compared with the SUVmax 〉 10 group （ 16 cases） , the aver- age diameter and SUVmax of the primary lesion in the SUVmax≤ 10 group （12 eases） become significantly smaller, and the num- ber of metastatic lension is significantly reduced after two cycles of chemotherapy. The rate of SUVmax change in these two groups is compared using t test analysis before and after treatment, and a significant difference is observed between these two groups （ P 〈 0.05 ） , which indieats that these cases of SUVinax ≤ 10 show more sensitive response to chemotherapy. Conclusion Multimo- dality imagings are of great value in the qualitative diagnosis, accurate staging, therapeutic and prognosis evaluation of SCLC. SU- Vmax may be used as a useful parameter for predicting chemotherapy response.

关 键 词：体层摄影术 X线计算机 小细胞肺癌 多模态影像 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]