结直肠癌腹膜转移的18F-FDG PET/CT影像学表现及其临床意义  

18F-FDG PET/CT imaging manifestations of peritoneal carcinomatosis from colorectal cancer and its clinical significance

作　　者：孙春锋 谭忠华[1] 高艳 朱建伟[2] 毛小英[1] 葛呈春[1] 包善磊 Sun Chunfeng;Tan Zhonghua;Gao Yan;Zhu Jianwei;Mao Xiaoying;Ge Chengchun;Bao Shanlei(Department of Nuclear Medicine,Affiliated Hospital of Nantong University,Nantong 226001,China;Department of Gastrointestinal Surgery,Affiliated Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学附属医院核医学科,226001 [2]南通大学附属医院胃肠外科,226001

出　　处：《中华核医学与分子影像杂志》2019年第11期653-656,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：吴阶平医学基金会临床科研课题(320675017210);南通市青年医学人才科研基金(WQ2016087)。

摘　　要：目的分析结直肠癌(CRC)腹膜转移(PC)的18F-脱氧葡萄糖(FDG)PET/CT影像学表现并探讨其临床意义。方法选取2016年5月至2018年8月间于南通大学附属医院行18F-FDG PET/CT检查、资料完整的46例有PC的CRC患者[男25例,女21例;年龄36~82(62.0±10.4)岁],采用腹膜癌指数(PCI)分级系统和PET/CT图像判读对PC病灶进行分析。采用两独立样本t检验、Kruskal-Wallis H检验进行统计学分析。结果46例CRC患者的PC在CT图像上的形态表现多样,在PET图像上均伴有FDG高代谢表现。按CRC原发灶位置分组,左半结肠组和直肠组间的PC病灶直径[(2.46±1.26)cm与(3.19±1.72)cm;t=-2.77,P<0.01]、右半结肠组和左半结肠组间的病灶最大标准摄取值[SUVmax(9.16±4.79与6.99±3.50;t=2.92,P<0.01)]差异均具有统计学意义。46例患者PCI评分为1~30分,以20分为界,右半结肠组、左半结肠组、直肠组PCI评分分布(≥20分与<20分)差异无统计学意义(H=0.242,P>0.05)。有10例患者出现腹、盆腔积液。结论18F-FDG PET/CT能较好地显示CRC患者的PC,综合该检查与PCI评分对PC的诊断和治疗具有重要意义。Objective To analyze 18F-fluorodeoxyglucose(FDG)PET/CT imaging manifestations in patients with peritoneal carcinomatosis(PC)from colorectal cancer(CRC)and investigate its clinical significance.Methods From May 2016 to August 2018,46 patients(25 males,21 females;age range:36-82(62.0±10.4)years)with PC from CRC who underwent 18F-FDG PET/CT imaging in Affiliated Hospital of Nantong University and had complete clinical data were retrospectively analyzed.The peritoneal carcinomatosis index(PCI)grading system was used to evaluate the PC lesions.Independent-sample t test and Kruskal-Wallis H test were used for data analysis.Results There were various CT manifestations of PC,while FDG metabolism on PET was observed in all 46 patients.Patients were divided into different groups according to the location of the primary CRC lesion.The diameter of PC lesion in the left colon group was(2.46±1.26)cm,which was significantly different from that of the rectum group((3.19±1.72)cm;t=-2.77,P<0.01).The maximum standardized uptake value(SUVmax)in the right colon group were significantly higher than that in the left colon group(9.16±4.79 vs 6.99±3.50;t=2.92,P<0.01).The PCI score ranged from 1 to 30 in 46 patients,and there was no significant difference in PCI score distribution(≥20 vs<20)among the right colon group,left colon group and rectum group(H=0.242,P>0.05).Ten patients had abdominal and pelvic effusion.Conclusion 18F-FDG PET/CT can well display the PC in patients with CRC,and the combination of PCI and 18F-FDG PET/CT plays an important role in the diagnosis and treatment of PC.

关 键 词：结直肠肿瘤 肿瘤转移 腹膜 正电子发射断层显像术 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R73[医药卫生—肿瘤]