^(18)F-FDG PET/CT诊断肾细胞癌伴下腔静脉癌栓侵犯下腔静脉壁  

^(18)F-FDG PET/CT for diagnosing renal cell carcinoma complicated withinferior vena cava tumor thrombi involving inferior vena cava wall

作　　者：祝安惠[1] 侯小艳[1] 张卫方[1] ZHU Anhui;HOU Xiaoyan;ZHANG Weifang(Department of Nuclear Medicine,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院核医学科,北京100191

出　　处：《中国医学影像技术》2024年第4期580-584,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的 观察^(18)F-FDG PET/CT诊断肾细胞癌(RCC)伴下腔静脉(IVC)癌栓侵犯IVC壁的价值。方法 回顾性分析71例接受手术治疗的RCC伴IVC癌栓患者,根据癌栓是否侵犯IVC壁分为侵犯组(n=40)及无侵犯组(n=31);比较组间一般资料和PET/CT特征,分析各指标诊断癌栓侵犯IVC壁的效能。结果 组间原发灶最大标准摄取值(SUV_(max))、癌栓比、癌栓最大横径、长径,以及病理类型差异均有统计学意义(P均<0.05)。癌栓比和癌栓最大横径为RCC伴IVC癌栓侵犯IVC壁的影响因素(P均<0.05)。以1.33为最佳截断值,根据癌栓比诊断RCC伴IVC癌栓侵犯IVC壁的敏感度为47.50%,特异度为87.10%,AUC为0.70;以3.45 cm为最佳截断值,根据癌栓最大横径诊断的敏感度为65.00%,特异度为87.10%,AUC为0.81;二者联合诊断敏感度为90.00%,特异度为77.40%,AUC为0.86。结论 以^(18)F-FDG PET/CT所获癌栓比及癌栓最大横径可用于术前诊断RCC伴IVC癌栓侵犯IVC壁。Objective To observe the value of ^(18)F-FDG PET/CT for diagnosing renal cell carcinoma(RCC)complicated with inferior vena cava(IVC)tumor thrombi involving IVC wall.Methods Data of 71 patients with RCC complicated with IVC tumor thrombi who underwent surgical treatment were retrospectively analyzed.The patients were divided into invasion group(n=40)or non-invasion group(n=31)based on whether tumor thrombi involved IVC wall.General information and PET/CT features were compared between groups,and the efficiency of each parameter for diagnosing tumor thrombi involving IVC wall was evaluated.Results There were significant differences of the maximum standard uptake value(SUV max),tumor thrombi ratio,the maximum transverse diameter and length as well as pathological type between groups(all P<0.05).Tumor thrombi ratio and the maximum transverse diameter were impact factors of RCC complicated with IVC tumor thrombi involving IVC wall(both P<0.05).Taken 1.33 as the best cutoff value,the sensitivity,specificity and area under the curve(AUC)of tumor thrombi ratio for diagnosing RCC complicated with IVC tumor thrombi involving IVC wall was 47.50%,87.10%and 0.70,respectively,while taken 3.45 cm as the best cutoff value of tumor thrombi maximum transverse diameter,the sensitivity,specificity and AUC was 65.00%,87.10%and 0.81,respectively.The sensitivity,specificity and AUC of the combination diagnosis of the above two was 90.00%,77.40%and 0.86,respectively.Conclusion Tumor thrombi ratio and the maximum transverse diameter of tumor obtained with ^(18)F-FDG PET/CT could be used for preoperative diagnosis of RCC complicated with IVC tumor thrombi involved IVC wall.

关 键 词：肾肿瘤 腔静脉 下 体层摄影术 X线计算机 正电子发射断层显像 

分 类 号：R737.11[医药卫生—肿瘤] R817.4[医药卫生—临床医学]