^(18)F-FDG双时相及^(18)F-FDG联合^(11)C-CHO PET/CT多模态显像在原发性肝细胞肝癌中的诊断价值  

Diagnostic value of 18F-FDG dual-phase and 18F-FDG combined with 11C-CHO PET/CT multimodality imaging in primary hepatocellular carcinoma

作　　者：邬心爱 邬永军 王雪梅[1] 王城[1] 王春梅[1] 牛瑞龙 Xin'ai Wu;Yongjun Wu;Xuemei Wang;Cheng Wang;Chunmei Wang;Ruilong Niu(Department of Nuclear Medicine,the Affiliated Hospital of Inner Mongolia Medical University,Key Laboratory of Molecular Imaging,Inner Mongolia Autonomous Region,Hohhot 010000,China;Department of Emergency,Dongsheng People's Hospital of Ordos City,Inner Mongolia Autonomous Region,Ordos 017000,China)

机构地区：[1]内蒙古医科大学附属医院核医学科,内蒙古自治区分子影像学重点实验室,呼和浩特010000 [2]内蒙古自治区鄂尔多斯市东胜区人民医院急诊科,017000

出　　处：《国际放射医学核医学杂志》2021年第3期139-146,共8页International Journal of Radiation Medicine and Nuclear Medicine

基　　金：内蒙古医科大学青年创新基金项目(YKD2017QNCX068)。

摘　　要：目的探讨^(18)F-氟脱氧葡萄糖(FDG)PET/CT双时相显像及^(18)F-FDG联合^(11)C-胆碱(CHO)PET/CT多模态显像对原发性肝细胞肝癌(HCC)的诊断价值。方法回顾性分析2016年3月至20^(18)年12月于内蒙古医科大学附属医院就诊的临床疑似原发肝占位性病变的73例患者的临床资料,其中男性41例、女性32例,年龄58~72岁;47例患者行^(18)F-FDG PET/CT双时相显像,26例患者行^(18)F-FDG联合^(11)C-CHO PET/CT多模态显像。分别测量并计算每个病变的最大标准化摄取值(SUV_(max))、肝本底SUV_(max)、肿瘤SUV_(max)/肝本底SUV_(max)比值(T/L)。以病变良恶性为状态变量,分别以^(18)F-FDG、^(18)F-FDG延迟、^(18)F-FDG双时相的SUV_(max)和^(18)F-FDG、^(11)C-CHO、^(18)F-FDG联合^(11)C-CHO的SUV_(max)为检验变量绘制受试者工作特征(ROC)曲线并进行两两比较,以组织病理学检查或临床随访结果为“金标准”,对比分析各种显像方法的诊断效能。计量资料的比较采用配对t检验;采用Z秩和检验比较各组间ROC曲线的差异。结果(1)^(18)F-FDG PET/CT双时相显像:47例患者共检出49个病变(其中32个为高代谢病变),经组织病理学检查或临床随访结果证实,40个为HCC(高分化8个、中低分化32个),9个为良性病变。中低分化HCC的病变SUV_(max)、肝本底SUV_(max)和T/L的差异均有统计学意义(t=4.51、-2.53、4.80,均P<0.05);高分化HCC的病变SUV_(max)和T/L的差异均有统计学意义(t=2.76、2.62,均P<0.05);良性病变SUV_(max)的差异无统计学意义(t=0.00,P>0.05)。^(18)F-FDG PET/CT显像分别与其延迟显像、双时相显像的SUV_(max)的ROC曲线间的差异均有统计学意义(Z=2.315、2.376,均P<0.05);而延迟显像与双时相显像的SUV_(max)的ROC曲线间的差异无统计学意义(Z=0.252,P>0.05)。(2)^(18)F-FDG联合^(11)C-CHO PET/CT显像:26例患者共检出26个病变(其中^(18)个为高代谢病变),经组织病理学检查或临床随访证实,22个为HCC(高分化9个、中低分�Objective To investigate the diagnostic value of^(18)F-fluorodeoxyglucose(FDG)PET/CT dual-phase and^(18)F-FDG combined with^(11)C-choline(CHO)PET/CT multimodal imaging in primary hepatocellular carcinoma(HCC).Methods Retrospective PET/CT analysis was conducted on 73 patients(41 males,32 females;age range:58–72 years)in the Affiliated Hospital of Inner Mongolia Medical University from March 2016 to December 20^(18).The patients had not been confirmed with primary hepatic space-occupying lesions,47 patients underwent^(18)F-FDG PET/CT dual-phase imaging,and 26 patients underwent^(18)F-FDG combined with^(11)C-CHO PET/CT multimodal imaging.The _(max)imum standardized uptake value(SUV_(max))of each lesion,the liver background,and the tumor SUV_(max)/liver background SUV_(max)(T/L)value of each lesion were measured.Positive or negative lesions were adopted as state variables,and SUV_(max)(^(18)F-FDG,^(18)F-FDG delay,and^(18)F-FDG dual phase)and SUV_(max)(^(18)F-FDG,^(11)C-CHO,and^(18)F-FDG combined with^(11)C-CHO)were used as test variables.The receiver operator characteristic(ROC)curve was compared in pairs,and the histopathological examination or clinical follow-up results were used as the gold standard.The diagnostic efficacy of various imaging methods was compared and analyzed.The measurement data were compared through a paired t test,and the Z-rank test was used to compare the differences in the ROC curves of the groups.Results(1)^(18)F-FDG PET/CT dual-phase imaging:a total of 49 lesions were detected in 47 patients(32 of them were hypermetabolic lesions).Histopathological examination or clinical follow-ups confirmed that 9 lesions were benign and 40 were HCC(8 of them were well-differentiated and 32 were moderately-poorly differentiated).The SUV_(max) differences in the lesion,liver background,and T/L values of the moderately-poorly differentiated HCC were statistically significant(t=4.51,-2.53,4.80;all P<0.05).The SUV_(max) differences in the lesion and T/L values of well-differentiated HCC were statistically s

关 键 词：癌 肝细胞 氟脱氧葡萄糖F18 胆碱 正电子发射断层显像术 体层摄影术 X线计算机 最大标准化摄取值 

分 类 号：R730.44[医药卫生—肿瘤] R735.7[医药卫生—临床医学]