^(18)F-FDG PET/CT在脉络膜黑色素瘤与脉络膜转移癌鉴别诊断中的应用价值  

Application value of ^(18)F-FDG PET/CT in differential diagnosis of choroidal melanoma and choroidal metastatic carcinoma

作　　者：罗诗雨 李眉[1] 罗莎[1] 王爽[1] 张娟 李萌 南潇 鲜军舫[2] Luo Shiyu;Li Mei;Luo Sha;Wang Shuang;Zhang Juan;Li Meng;Nan Xiao;Xian Junfang(Department of Nuclear Medicine,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Department of Radiology,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院核医学科,北京100730 [2]首都医科大学附属北京同仁医院放射科,北京100730

出　　处：《首都医科大学学报》2022年第6期867-872,共6页Journal of Capital Medical University

基　　金：北京市医院管理中心“登峰”计划专项(DFL20190203)。

摘　　要：目的分析脉络膜黑色素瘤和脉络膜转移癌患者氟-18-脱氧葡萄糖(^(18)F-fluorodeoxyglucose,^(18)F-FDG)正电子发射型计算机断层显像/电子计算机断层显像(positron emission tomography/computed tomography,PET/CT)影像特点及代谢参数,探讨其在两者的诊断及鉴别中的应用价值。方法回顾性分析2020年5月至2022年3月首次因眼部症状就诊,在首都医科大学附属北京同仁医院核医学科行^(18)F-FDG PET/CT检查,并经手术病理证实或临床最终诊断为脉络膜黑色素瘤或脉络膜转移癌的患者的影像和代谢参数。对比两组间影像学表现及^(18)F-FDG PET代谢参数,后者包括病灶最大标准化摄取值(maximum standardized uptake value,SUV_(max))、峰值标准摄取值(peak standardized uptake value,SUV_(peak))、病灶糖酵解总量(total lesion glycolysis,TLG)。应用Spearman相关性分析,评价代谢参数与病变大小之间的相关性。结果共纳入76例患者,其中脉络膜黑色素瘤58例(58只眼)、脉络膜转移癌18例(18只眼)。两组间性别、年龄、患侧差异均无统计学意义(均P>0.05)。两组间病变位置(χ^(2)=9.263,P=0.041)、形状(χ^(2)=21.735,P<0.001)差异有统计学意义。脉络膜黑色素瘤组平均隆起高度明显高于脉络膜转移癌组(t=2.539,P=0.013);两组之间基底最大径差异无统计学意义(P>0.05)。在代谢参数中,脉络膜黑色素瘤组SUV_(max)低于脉络膜转移癌组(P<0.05),两组间SUV_(peak)及TLG差异无统计学意义(均P>0.05)。脉络膜黑色素瘤组病灶SUV_(max)、SUV_(peak)、TLG与病变基底最大径(r=0.528、0.613、0.732,均P<0.001)、隆起高度(r=0.521、0.605、0.730,均P<0.001)均呈正相关。脉络膜转移癌组SUV_(peak)、TLG与病变基底最大径(r=0.528、0.661,P=0.024、0.003)、隆起高度(r=0.591、0.688,P=0.010、0.002)均呈正相关,而SUV_(max)与病变基底最大径、隆起高度均无显著相关性(均P>0.05)。结论^(18)F-FDG PET/CT影像表现及代谢参数SUV_(max)�Objective To analyze the imaging characteristics and metabolic parameters of fluoro-18-deoxyglucose(^(18)F-FDG)positron emission tomography/computed tomography(PET/CT)in patients with choroidal melanoma and choroidal metastatic carcinoma,and to explore its clinical application value in the diagnosis and differentiation of the two diseases.Methods The patients that underwent ^(18)F-FDG PET/CT examination in the Department of Nuclear Medicine,Beijing Tongren Hospital,Capital Medical University from May 2020 to March 2022 and finally diagnosed as choroidal melanoma or choroidal metastatic carcinoma were enrolled.The CT imaging features and ^(18)F-FDG PET metabolic parameters of the two diseases were compared with each other,the latter including maximum standardized uptake value(SUV_(max)),_(peak) standardized uptake value(SUV _(peak)),and total lesion glycolysis(TLG).Chi-square test,Fisher exact test,two independent samples t-test and rank sum test were used to compare the differences of the above mentioned between the two group.Spearman correlation analysis was used to evaluate the correlation between metabolic parameters and lesion size.Results A total of 76 patients were enrolled,including 58 cases of choroidal melanoma and 18 cases of choroidal metastatic carcinoma.There were no significant differences in gender,age,and affected side between the two groups(all P>0.05).There were statistically significant differences in the location(χ^(2)=9.263,P=0.041)and shape(χ^(2)=21.735,P<0.001)of lesions between the two groups.The thickness of the choroidal melanoma group was significantly higher than that of the choroidal metastatic carcinoma group(t=2.539,P=0.013).There was no significant difference in the largest basal diameter between the two groups(P>0.05).The SUV_(max) of the choroidal melanoma group was lower than that of the choroidal metastatic carcinoma group(P<0.05).There was no significant difference in SUV _(peak) and TLG between the two groups(all P>0.05).In the choroidal melanoma group,SUV max,SUV _(peak),a

关 键 词：脉络膜黑色素瘤 脉络膜转移癌 正电子发射型计算机断层显像/电子计算机断层显像 代谢参数 鉴别诊断 

分 类 号：R73[医药卫生—肿瘤]