^(18)F-FDG PET/CT在结直肠息肉样病变中的诊断价值  

The value of ^(18)F-FDG PET/CT in the diagnosis of colorectal polypoid lesions

作　　者：沈智辉 穆晨[1] 宁静[1] 王瑞民[1] 关志伟[1] 徐白萱[1] SHEN Zhi-hui;MU Chen;NING Jing;WANG Rui-min;GUAN Zhi-wei;XU Bai-xuan(Department of Nuclear Medicine,First Medical Centre,PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心核医学科,北京100853

出　　处：《中国临床医学影像杂志》2021年第7期494-499,共6页Journal of China Clinic Medical Imaging

基　　金：国家自然科学基金(82071958);国家自然科学基金(61671204)。

摘　　要：目的:探讨^(18)F-FDG PET/CT显像在结直肠息肉样病变中的临床诊断价值。方法:回顾性分析2017年1月—2019年5月肠镜检查发现结直肠息肉样病变60例患者,行^(18)F-FDG PET/CT显像,将所得PET/CT诊断结果与肠镜下病变大小、形态及活检病理结果进行对比分析。结果:60例患者中,^(18)F-FDG PET/CT显像发现结直肠异常高摄取48例,阳性率为80%,其中腺瘤17例,增生性息肉3例,高级别上皮内瘤变4例,腺瘤伴局部癌变9例,结直肠癌15例。48例患者中,隆起型病变21例,平坦型3例,侧向发育型肿瘤24例。48例患者中,病变大小、癌胚抗原(CEA)与最大标准摄取值(SUVmax)具有相关性(r=0.531、r=0.785,P均<0.001)。良性病变、癌前病变及恶性肿瘤组间,病变大小及SUVmax均提示各组间有显著差异(F分别为20.56、15.20,P均<0.001),其中良性病变组与恶性病变组有显著差异(P<0.001)。隆起型病变、平坦型病变及侧向发育型肿瘤组间病变大小有显著差异(F=11.44,P<0.001),其中隆起型病变组与侧向发育型肿瘤组有显著差异(P<0.001);SUVmax提示各组间无显著差异(P=0.131),其中隆起型病变组与侧向发育型肿瘤组无显著性差异(P=0.186)。通过ROC曲线计算,SUVmax及病变大小在鉴别良性和恶性/癌前病变的最佳临界值分别为6.95、1.95 cm,AUC 0.874、0.852,敏感度84.8%、82.6%,特异性78.6%、71.4%。结论:^(18)F-FDG PET/CT显像在结直肠息肉样病变中具有一定的临床诊断价值,对于病变的良恶性鉴别具有重要的临床价值。Objective:To investigate the clinical value of ^(18)F-FDG PET/CT imaging in the diagnosis of colorectal polypoid lesions.Methods:From January 2017 to May 2019,we retrospectively analyzed 60 patients with colorectal polypoid lesions found by colonoscopy.All of them underwent^(18)F-FDG PET/CT scans.Then,we compared the diagnostic results of PET/CT with their morphology under the colonoscopy and pathological findings.Results:Among the 60 patients,^(18)F-FDG PET/CT imaging detected abnormal high uptakes in colorectum in 48 cases,with positive rate of 80%.Among the 48 patients,17 had adenomas,3 cases had hyperplastic polyps,4 cases suffered from the high-grade intraepithelial neoplasia,9 cases were diag-nosed as adenoma with local carcinogenesis and 15 cases were revealed as colorectal cancer.Of the 48 patients,21 lesions presented with protruded lesions,3 cases presented with flat shapes,and 24 cases shaped as lateral developmental tumors.A-mong the 48 patients shown positive on PET/CT,the lesion size and CEA were detected associated with SUVmax(r=0.531,r=0.785,P<0.001).One-way analysis of variance was performed between benign lesions,precancerous ones and malignant tu-mors.As a result,lesion size and SUVmax values showed significant differences between the groups,with F values of 20.56 and 15.20 respectively(P<0.001).There was a significant difference between the benign and malignant lesions(P<0.001).Oneway analysis of variance was conducted among protruded lesions,flat types,and lateral developmental tumors.The lesion size suggested significant difference between the groups,whose F value was 11.44(P<0.001).The difference between protruded lesions and lateral developmental tumors were remarkably significant(P<0.001).However,SUVmax showed no significant difference between the groups,whose F value was 2.14 and P value was 0.131.There was no significant difference between the protruded lesions and lateral developmental tumors,whose P value was 0.186.Based on the ROC analysis,the sensitivity,specificity and area under t

关 键 词：肠息肉病 正电子发射断层显像计算机体层摄影术 氟脱氧葡萄糖F18 

分 类 号：R574.6[医药卫生—消化系统] R817.4[医药卫生—内科学]