口服小剂量利尿剂延迟^(18)F-FDG PET/CT显像诊断泌尿生殖系统肿瘤  

Delayed ^(18)F-FDG PET/CT with oral small dosage diuretics in diagnosing urogenital cancers

作　　者：邹琼[1] 焦举[1] 杨婷[1] 吕殷婷 江淑琴 曹素娥[1] 张勇[1] 

机构地区：[1]中山大学附属第三医院核医学科,广东广州510630

出　　处：《中国医学影像技术》2018年第2期279-283,共5页Chinese Journal of Medical Imaging Technology

基　　金：广东省科技计划项目(2014A020212153);广东省自然科学基金(2015A030313106)

摘　　要：目的评估口服小剂量利尿剂延迟^(18 )F-FDG PET/CT显像对泌尿生殖系统恶性肿瘤的诊断价值。方法将可疑泌尿生殖系统肿瘤的患者分为常规剂量利尿组(n=12)和小剂量利尿组(n=35),常规PET/CT全身显像后分别口服40mg、20mg呋塞米,充分水化后行延迟PET/CT显像。比较口服利尿剂前后尿液最大标准摄取值(SUV_(max))、病灶/尿液SUV_(max)比值(T/U)的差异。计算小剂量利尿组的诊断泌尿生殖系统恶性肿瘤的效能。结果小剂量利尿组和常规剂量利尿组组内常规显像和延迟显像尿液SUV_(max)和T/U差异均有统计学意义(P均<0.05),组间常规显像和延迟显像SUV_(max)和T/U差异均无统计学意义(P均>0.05)。小剂量利尿组延迟及常规显像的灵敏度96.77%(30/31)、61.29%(19/31),特异度75.00%(3/4)、50.00%(2/4),阳性预测值96.77%(30/31)、90.48%(19/21),阴性预测值75.00%(3/4)、14.29%(2/14),准确率94.29%(33/35)、60.00%(21/35);灵敏度和准确率差异有统计学意义(P<0.001)。结论口服小剂量呋塞米利尿剂延迟PET/CT显像可达到与常规剂量利尿法相同的效果,有助于诊断泌尿生殖系统恶性肿瘤。Objective To investigate the value of delayed 18F-FDG PET/CT with oral intake small dosage diuretics for diagnosing urogenital cancers. Methods Patients with suspected urogenital system cancers were divided into routine dosage diuretic group （n=12） and small dosage diuretics group （n=35）. All patients underwent whole-body PET/CT followed by delayed scanning after oral 40 mg or 20 mg Furosemide respectively, The urine maximum standard uptake value （SUVmax） and T/U （the ratio of urine and lesion SUVmax） before and after diuresis were compared respectively. Diagnostic efficacy for malignant urogenital system cancers of small dosage group was calculated. Results The urine SUVmax and T/U were statistically different between routine whole body and delayed scans in both groups （P〈0.05）. SUVmax and T/U of routine and delayed scans had no statistical differences between the two groups （P〉0.05）. In small dosage group, the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of delayed imaging and routine imaging was 96.77% （30/31）and 61.29% （19/31）, 75.00%（3/4） and 50.00% （2/4）, 96.77% （30/31） and 90.48% （19/21）, 75.00% （3/4） and 14.29% （2/14）, 94.29% （33/35） and 60.00% （21/35）, respectively. The sensitivity and accuracy were statistically different between routine and delayed imaging （P〈0. 001）. Conclusion Delayed PET/CT imaging with oral small dosage Furosemide has the same efficacy as PET/CT using routine dosage diuretics, which is useful for diagnosing urogenital cancers.

关 键 词：泌尿生殖系统肿瘤 利尿 氟脱氧葡萄糖F18 正电子发射断层显像术 体层摄影术 螺旋计算机 

分 类 号：R737[医药卫生—肿瘤] R817.4[医药卫生—临床医学]