正电子发射计算机断层CT融合显像在头颈肿瘤中的诊断价值  

Clinical evaluation of 18-fluorine fluorodeoxyglucose positron emission tomography -CT imaging in head and neck tumors

作　　者：李湘平[1] 梁勇[1] 刘雄[1] 王全师[2] 吴湖炳[2] 

机构地区：[1]第一军医大学南方医院耳鼻咽喉科,广州510515 [2]第一军医大学南方医院核医学科,广州510515

出　　处：《中华耳鼻咽喉科杂志》2004年第5期298-301,共4页Chinese Journal of Otorhinolaryngology

摘　　要：目的　探讨18氟 脱氧葡萄糖 (18 fluorinefluorodeoxyglucose ,18F FDG)正电子发射计算机断层显像 (positronemissiontomography ,PET) CT融合显像在头颈肿瘤的原发灶诊断、复发的检测和诊断分析未知原发肿瘤转移癌中的诊断价值。方法　 2 7例已确诊头颈部原发肿瘤或转移癌 ,进行18F FDGPET CT全身显像 ,并与临床资料对照。结果　鼻咽癌组治疗前 4例PET CT均查出原发灶 ,其中 2例确诊有颈淋巴结转移 ,与病理检查结果一致。鼻咽癌放疗后 12例中 4例PET CT检查鼻咽部及颈部淋巴结均为阴性表现 ,符合临床和病理诊断 ;2例放疗后原发灶复发经病理检查证实 ,其中 1例查出颈部淋巴结及全身多处转移经随访证实 ;6例鼻咽原发灶PET CT检查阴性表现 ,但 4例颈部显示淋巴结转移经病理检查证实 ,2例肺部、纵隔等有转移灶未经病理检查证实。未知原发肿瘤颈淋巴转移组4例患者PET CT均检出原发灶 ,3例病理检查证实 ,另 1例未经病理检查证实。其他头颈肿瘤组 7例治疗后患者中 ,2例患者无复发转移表现 ,5例不同部位肿瘤检出原发部位复发或颈淋巴结转移 ,有 4例经病理检查证实 ,1例放弃治疗未经病理检查证实。结论　18F FDGPET CT将PET提供的肿瘤代谢图像和CT提供的解剖图像结合 ,对头颈原发肿瘤诊断 。Objective To study the clinical value of 18-fluorine fluorodeoxyglucose( 18F-FDG) positron emission tomography(PET)-CT imaging in diagnosis and detection of primary tumors and suspicious recurrence in head and neck cancers. Methods Twenty-Seven patients with primary tumors or metastases in head and neck were underwent 18F-FDG PET-CT imaging, and compared with clinical data. Results 1.In 4 NPC diagnosed pre-radiation patients the 18F-FDG PET-CT imaging in nasopharynx was all positive , 2 of them were detected with neck lymph node metastases, which were confirmed later histopathologically. In 12 NPC cases after radiation, 4 were not found any evidence of tumor with PET-CT imaging and clinically, 4 were detected neck recurrence and confirmed histopathologically, 2 hadremote metastases confirmed by other imaging, 2 were detected and confirmed recurrence in primary sites and one of them in regional and remote site. 2.In 4 neck metastatic patients with unknown primary tumor,the primary tumors were all identified, 3 of them were confirmed histopathologically. 3.Seven patients with other head and neck tumors after therapy underwent 18F-FDG PET-CT imaging. Two patients had no evidence of recurrence. Five patients were detected recurrence or metastases, 4 of them were confirmed histopathologically, one of them refused biopsy Conclusions With metabolic image of PET and anatomic image of CT, 18F-FDG PET-CT is a kind of very useful way in diagnosing primary tumor and detecting the recurrence and metastases in patients with head and neck tumor.

关 键 词：正电子发射计算机断层-CT融合显像 头颈肿瘤 诊断 治疗 ^18氟-脱氧葡萄糖 

分 类 号：R739.91[医药卫生—肿瘤]