双时相18F-FDG PET/CT显像诊断不同类型肝外胆管癌  

Dual-phase 18F-FDG PET/CT in diagnosis of different types of extrahepatic cholangiocarcinomas

作　　者：冼伟均[1] 冯彦林[1] 杨明[1] 王颖[1] 鲁胜男[1] XIAN Weijun;FENG Yanlin;YANG Ming;WANG Ying;LU Shengnan(Department of Nuclear Medicine,the First People's Hospital of Foshan,Foshan 528000,China)

机构地区：[1]佛山市第一人民医院核医学科,广东佛山528000

出　　处：《中国医学影像技术》2020年第6期878-882,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨双时相18F-FDG PET/CT显像诊断不同类型肝外胆管癌(EHCC)的价值。方法回顾性分析71例疑诊EHCC并接受双时相18F-FDG PET/CT显像患者,根据PET/CT显像及病理结果将其分为结节型EHCC组(n=20)、非结节型EHCC组(n=34)及良性病变组(n=17),计算双时相PET/CT显像的诊断效能;比较双时相PET/CT显像中3组阳性显像病灶最大标准摄取值(SUV max)、肿瘤SUV mean/肝脏SUV max(T/L)及滞留指数(RI)的差异,以ROC曲线比较各参数AUC,并分析其临界值。结果早期18F-FDG PET/CT显像及延迟显像对非结节型EHCC的诊断灵敏度分别为70.59%(24/34)和73.53%(25/34)。显像阳性患者中,结节型EHCC组SUV max、T/L均明显高于良性病变组(P均<0.05)。非结节型EHCC组SUV max、T/L与良性病变组差异均无统计学意义(P均>0.05),但SUV滞留指数(RI SUV)差异存在统计学意义(Z=-2.638,P=0.007),RI SUV最佳诊断临界值为6.0%。联合应用早期SUV max>3.1和RI SUV>6.0%可明显提高对非结节型EHCC的诊断灵敏度和准确率。结论双时相18F-FDG PET/CT显像有助于提高对非结节型EHCC的诊断效能。Objective To explore the value of dual-phase 18F-FDG PET/CT in diagnosis of different types of extrahepatic cholangiocarcinomas(EHCC).Methods Data of 71 patients with suspected EHCC who underwent preoperative dual-phase 18F-FDG PET/CT scanning were retrospectively analyzed.According to 18F-FDG PET/CT imaging and pathological results,the patients were divided into mass-forming EHCC group(n=20),non-mass-forming EHCC group(n=34)and benign diseases group(n=17).The diagnostic efficiency of dual-phase 18F-FDG PET/CT was calculated.The maximal standardized uptake value(SUV max),tumor SUV max/liver SUV mean ratio(T/L)and retention index(RI)of dual-phase 18F-FDG PET/CT were compared in those with positive findings among 3 groups.ROC curves were used,and the AUC were compared.Results The diagnostic sensitivity of early and delayed 18F-FDG PET/CT for non-mass-forming EHCC was 70.59%(24/34)and 73.53%(25/34),respectively.In all patients with positive findings,SUV max and T/L of mass-forming EHCC were higher than those of benign diseases(all P<0.05).There was significant difference of retention index of SUV(RI SUV,Z=-2.638,P=0.007)but not of SUV max nor T/L between non-mass-forming EHCC group and benign diseases group(all P>0.05).The best cut-off of RI SUV was 6.0%.The diagnostic sensitivity and accuracy of dual-phase 18F-FDG PET/CT for non-mass-forming EHCC can be improved with the combination of early phase SUV max>3.1 and RI SUV>6.0%.Conclusion Dual-phase 18F-FDG PET/CT might be helpful to improving diagnostic accuracy of non-mass-forming EHCC.

关 键 词：胆管肿瘤 正电子发射断层显像术 体层摄影术 X线计算机 氟脱氧葡萄糖F18 

分 类 号：R735.8[医药卫生—肿瘤] R817.4[医药卫生—临床医学]