18F-FDGPETCT显像在难确诊性鼻咽癌中的临床价值  

Clinical Application of 18F-FDG PET CT Imaging in Difficult to Diagnose Nasopharyngeal Carcinoma

作　　者：秦贵磷 黄斌豪[1] 段晓蓓[1] QIN Gui-lin;HUANG Bin-hao;DUAN Xiao-bei(Department of Nuclear Medicine,Jiangmen Central Hospital,Guangdong 529000,China)

机构地区：[1]江门市中心医院核医学科,广东529000

出　　处：《影像技术》2022年第1期16-21,共6页Image Technology

基　　金：江门市科学技术局2020年度医疗卫生领域科技计划项目(2020YLA029)。

摘　　要：目的:探讨18F-FDGPETCT显像在难确诊性鼻咽癌中的临床应用价值。方法:回顾性分析2020年3月-2021年2月我院临床高度怀疑鼻咽癌的60例患者,首次或多次行鼻咽镜病理活检阴性,行常规18F-FDGPET/CT检查,根据PET/CT结果引导再次行鼻咽镜病理活检。将上述患者分为两组,以最终病理结果为金标准,分为阳性组(鼻咽癌组)及阴性组(非鼻咽癌组)。收集临床资料,包括年龄、性别、家族史、EB病毒相关抗体及病理等。分析难确诊性鼻咽癌原发灶中PET/CT的临床应用价值、影像学特征、鼻咽癌淋巴结转移情况。结果:PET/CT鼻咽癌原发灶在左侧壁12例(33.33%)、右侧壁16例(44.44%)、顶后壁+双侧壁8例(22.22%)、平均大小(17.68±5.63)cm^(3)、平均最大标准化摄取值(the maximum standardized uptake value,SUVmax)为(8.36±0.77)。PET/CT诊断难确诊性鼻咽癌的准确率为73%(44/60);阳性预测值为100%(36/36),阴性预测值为33%(8/24)。结合病灶的部位再进行诊断(单侧为恶性,双侧为良性),准确率提高到约为80%(48/60),阴性预测值提高到20/24(83.3%)。大部分炎症病灶一般表现为双侧鼻咽部对称性FDG摄取增高;恶性者大部分表现为单侧病灶,除非病灶范围较大形成肿物,则可能累及双侧。两组间的EB病毒相关抗体、SUVmax差异具有统计学意义(P<0.05)。病理类型中低分化鳞癌与高分化鳞癌的SUVmax值差异有统计学意义(P<0.05),前者高于后者。鼻咽癌淋巴结转移率高达69.81,数量平均(4.68±1.63)个,SUVmax在PET/CT图像亦较高。结论:在难确诊性鼻咽癌患者中,18F-FDGPETCT显像的准确率及阳性预测值较高,具有临床应用价值。Objective:To observe the clinical application of 18F-FDG PET CT imaging in difficult to diagnose nasopharyngeal carcinoma.Methods:retrospective analysis(from May 2020 to February 2021)of 60 patients with highly suspected nasopharyngeal carcinoma in our hospital who underwent na-sopharyngoscopic pathological biopsy for the first time or for many times,were pathologically negative,underwent 18f-fdgpet/CT in our department,and then guided nasopharyngoscopic pathological biopsy again according to the results of PET/CT.The above patients were divided into two groups:PET/CT positive group and negative group.The age,sex,family history,EB virus infection and pathological type were determined.To analyze the imaging features of primary lesions of nasopharyngeal carcinoma on PET/CT and lymph node metastasis of nasopharyngeal carcinoma.Results:the primary lesions of PET/CT nasopharyngeal carcinoma were located in the left wall in 12 cases(33.33%),the right wall in 16cases(44.44%),the parietal posterior wall dable wall in 8 cases(22.22%),the average size was(17.68±5.63)cm3,and the average maximum standardized uptake value(SUVmax)was(8.36±0.77).The accuracy of PET/CT in the diagnosis of difficult to diagnose nasopharyngeal carcinoma was 73%(44/60).Combining the site of the lesion for diagnosis(malignant unilateral and benign bilateral),the increased accuracy of pet/ct in refractory NPC diagnosis to about 80%(48/60)and the negative predictive value to 20/24(83.3%).Most inflammatory lesions generally show higher fdg uptake of bilateral nasopharyngeal symmetry,and most malignant patients show unilateral lesions that may involve bilateral involvement unless the range of lesions is large.There were significant differences in EB virus related antibody and SUVmax between the two groups(P<0.05).There was significant difference in SUVmax between poorly differentiated squamous cell carcinoma and highly differentiated squamous cell carcinoma(P<0.05),and the former was higher than the latter.The lymph node metastasis rate of nasopharyng

关 键 词：18F-FDGPETCT 显像技术 难确诊性 鼻咽癌 诊断价值 影像学特征 

分 类 号：R739.62[医药卫生—肿瘤]