^(18)F-FDG PET/CT延迟显像诊断结直肠癌肝转移瘤的价值  

^(18)F-FDG PET/CT Delay Imaging in Diagnosing Colorectal Cancer Liver Metastases

作　　者：杨建峰[1] 黄亚男 张雅萍[1] 罗周烨 魏建国[2] YANG Jianfeng;HUANG Yanan;ZHANG Yaping;LUO Zhouye;WEI Jianguo(Department of Radiology,Shaoxing People's Hospital,Shaoxing 312000,China;不详)

机构地区：[1]绍兴市人民医院放射科,浙江绍兴312000 [2]绍兴市人民医院病理科,浙江绍兴312000

出　　处：《中国医学影像学杂志》2021年第12期1227-1231,共5页Chinese Journal of Medical Imaging

基　　金：浙江省医药卫生科研基金(2019KY711);绍兴市肿瘤功能分子成像与介入诊疗重点实验室资助项目。

摘　　要：目的探讨^(18)F-FDG PET/CT延迟显像对结直肠癌肝转移瘤(CRCLM)的诊断价值。资料与方法回顾性收集35例结直肠癌伴肝结节患者的资料,根据结节的病理或随访结果分为转移组25例和良性组10例。35例均行^(18)F-FDG PET/CT肝脏延迟显像和早期全身常规显像,采用受试者工作特征(ROC)曲线评价两种显像方法对结直肠癌肝转移的诊断效能。比较两组在延迟和常规显像的最大标准化摄取值(SUVmax)、SUVmax比值、滞留指数的差异,采用ROC曲线分析各参数诊断CRCLM的敏感度及特异度。结果常规显像C指数、敏感度、特异度、准确率、阳性预测值和阴性预测值分别为0.80、80.0%、80.0%、80.0%、90.9%和61.5%,延迟显像分别为0.98、96.0%、100%、97.1%、100%和90.9%,延迟显像对两组患者C指数的诊断效能高于常规显像(Z=2.355,P=0.019)。转移组常规与延迟显像病灶的SUVmax、SUVmax比值和滞留指数大于良性组(Z=13.87、13.07、13.60、14.70,t=6.91,P均<0.05)。ROC曲线下面积分别为0.908、0.904、0.892、0.917、0.764。转移组的SUVmax比值在延迟显像高于常规显像[2.2(2.0,3.1)比1.6(1.3,1.9);Z=7.92,P=0.005]。结论^(18)F-FDG PET/CT延迟显像对结直肠癌肝内结节的诊断效能高于常规显像。PET/CT延迟显像与常规显像病灶的SUVmax、SUVmax比值、滞留指数诊断CRCLM具有较高的敏感度和特异度,其中延迟显像的SUVmax比值诊断CRCLM较常规显像更具有优势。Purpose To explore the diagnostic value of ^(18)F-FDG PET/CT delay imaging in colorectal cancer liver metastases(CRCLM).Materials and Methods Thirty-five cases of colorectal cancer with liver nodules were retrospectively collected and divided into two groups,including the metastasis group(n=25)and the benign group(n=10)confirmed by the pathology or followed results of liver lesions.All cases were performed ^(18)F-FDG PET/CT liver delay imaging and conventional imaging.The receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficiency between ^(18)F-FDG PET/CT liver delay imaging and the whole body early conventional imaging.The maximum standardized uptake value(SUVmax),the ratio of SUVmax,and the retention index between two groups were compared,the sensitivity and specificity of all parameters in metastasis group with CRCLM were further analyzed via ROC curve.Results The C-index,sensitivity,specificity,accuracy,positive predictive value and negative predictive value of conventional imaging was 0.80,80.0%,80.0%,80.0%,90.9%and 61.5%,respectively;those of ^(18)F-FDG PET/CT liver delay imaging was 0.98,96.0%,100%,97.1%,100%and 90.9%,respectively.The diagnostic efficiency of C-index of delay imaging was significantly higher than that of conventional imaging(Z=2.355,P=0.019).The SUVmax,ratio of SUVmax and retention index in the metastasis group were significantly higher than those of benign group in both imaging methods(Z=13.872,13.07,13.60,14.70,t=6.91,all P<0.05),and the area under ROC curve were 0.908,0.904,0.892,0.917 and 0.764,respectively.The ratio of SUVmax of delay imaging in the metastasis group was significantly higher than that of conventional imaging[2.2(2.0,3.1)vs.1.6(1.3,1.9);Z=7.92,P=0.005].Conclusion ^(18)F-FDG PET/CT delay imaging has better diagnostic efficiency than conventional imaging in the colorectal cancer patients with liver nodules.The SUVmax,ratio of SUVmax and retention index of both imaging has high sensitivity and specificity and ratio of SUVmax at delay imagin

关 键 词：结直肠肿瘤 肿瘤转移 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 病理学 外科 随访 

分 类 号：R730.44[医药卫生—肿瘤] R735.3[医药卫生—临床医学]