^(18)F-FDG符合线路成像在肿瘤及其转移灶探测中的临床应用  

The clinic application of ^(18)F-FDG coincidence imaging in detecting tumors and metastases

作　　者：李林法[1] 朱阳军[1] 沈文华[1] 赵葵[1] 闻世凤[1] 罗旭光[1] 程维荷[1] 

机构地区：[1]浙江大学医学院附属第一医院核医学科,杭州310003

出　　处：《核技术》2003年第11期871-874,共4页Nuclear Techniques

摘　　要：为评价18氟-脱氧葡萄糖(18F-FDG)符合线路成像在诊断肿瘤性质或肿瘤转移的临床应用价值,对87例临床怀疑为恶性肿瘤或肿瘤转移复发的患者,空腹肘静脉注射18F-FDG 259-298MBq后40-160 min,采用GEHAWKEYE符合线路单光子发射型计算机断层(SPECT)进行卧位显像;经迭代法处理和重建,获得经X线衰减校正后的横断面、冠状面和矢状面三维断层图像;以目测双盲阅片进行诊断分析,并与手术病理或CT/MRI以及临床随访作出的最后诊断进行了对比。结果显示:87例患者中显像阳性61例,其中假阳性5例,真阳性56例;阴性26例,其中假阴性2例,真阴性24例。87例患者中共检出病灶136个,其中淋巴结和远处转移灶41个。符合线路成像对肿瘤或其转移灶诊断的灵敏度为96.6％(56/58),特异性为82.8％(24/29),阳性预测值91.8％(56/61),阴性预测值92.3％(24/26),诊断准确率92.0％(80/87)。表明18F-FDG符合线路成像对于肿瘤的诊断具有较高的灵敏度和特异性;在肿瘤定性、肿瘤复发和转移灶的寻找方面有着独特的优势,是临床肿瘤诊断研究的有效手段。To evaluate the clinical usefulness of 18F-FDG coincidence imaging in detecting tumors and metastases, 87 patients with suspected malignant or recurrent tumors were studied. 259-298MBq I8F-FDG was injected, then 40 -60 min after injection the patients underwent I8F-FDG coincidence imaging using GE HAWKEYE Coincidence SPECT in supine position. After reconstruction using iterative algorithm,we obtained the transaxial,coronal and sagittal sections with X-ray attenuation correction. The images were interpreted visually, and also analyzed with operative, histological, CT/MRI and follow-up studies. There were 61 positives, including 5 false-positives and 56 true-positives; 26 negatives, including 2 false-negatives and 24 true-negatives in altogether 87 patients. 136 lesions were detected by 18F-FDG coincidence imaging,including 41 lymph node and remote metastases. In all patients with suspected malignant tumors, the sensitivity, specificity, positive predictive values, negative predictive values and accuracy of 18FHFDG coincidence imaging were 96.6% (56/58), 82.8% (24/29), 91.8% (56/61), 92.8% (24/26) and 92.0% (80/87) respectively. 18F-FDG coincidence imaging had high sensitivity and specificity in tumor diagnosis, and had unique advantages in ascertaining tumor's nature and in detecting recurrence or metastases, and it was also a valuable diagnostic and investigative method for patients with cancer.

关 键 词：^18氟-脱氧葡萄糖 符合线路SPECT 肿瘤 

分 类 号：R817.4[医药卫生—影像医学与核医学] R814.42[医药卫生—放射医学]