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山东大学学报(医学版) ›› 2009, Vol. 47 ›› Issue (5): 83-.

• 论文 • 上一篇    下一篇

增强MDCT联合FDG PET/CT在食管癌分期中的应用

黄召勤 侯中煜 谭茹 葛全序 姚树展 刘庆伟   

  1. 1. 山东大学附属省立医院医学影像科, 济南 250021;  2. 山东省威海市立医院放射科, 山东 威海 264200
  • 收稿日期:2008-12-19 出版日期:2009-06-16 发布日期:2009-05-16
  • 通讯作者: 刘庆伟(1958- ),男,教授,博导,主要从事肿瘤性病变(肺癌)的早期解剖和功能影像综合评价研究。
  • 作者简介:黄召勤(1979- ),男,硕士研究生,主要从事肿瘤影像诊断及功能成像研究。
  • 基金资助:

    山东省自然科学基金项目(Y2005C03),(Y2008C108)。

Application of contrast-enhanced MDCT in combination with FDG PET/CT in esophageal cancer staging

 HUANG Shao-Qi, HOU Zhong-Yu, TAN Ru, GE Quan-Xu, YAO Shu-Zhan, LIU Qing-Wei   

  1. 1. Department of Radiology, Provincial Hospital Affiliated to Shandong University, Jinan 250021; 2. Department of Radiology, Weihai Municipal Hospital, Weihai 264200, Shandong, China
  • Received:2008-12-19 Online:2009-06-16 Published:2009-05-16

摘要:

 目的 探讨MDCT增强扫描和FDG PET/CT显像联合应用评价食管癌原发肿瘤及淋巴结转移的价值。  方法 所有79例食管癌患者均在1周内接受FDG PET/CT检查、增强扫描MDCT检查及手术治疗,并有明确病理结果。观察食管癌原发病灶、周围组织器官有无浸润、转移淋巴结的部位及组数,MDCT图像、FDG PET/CT图像及两者联合诊断结果与病理结果对照。  结果 MDCT、FDG PET/CT及两者联合对病灶检出率的敏感度分别为:78.3%、96.4%与96.4%。MDCT、FDGPET/CT及两者联合诊断T4期肿瘤的敏感度分别为:70.0%、90%、90%;特异度分别为94.5%、68.5%、98.6%;准确度分别为91.6%、71.1%、97.6%;两者联合与单独FDG PET/CT的特异度(P=0.0)及准确度(P=0.0)间差异有统计学意义。增强MDCT、FDG PET/CT及两者联合诊断淋巴结转移的敏感度分别为:70.5%、86.1%、94.3%;特异度分别为:95.9%、97.1%、98.6%;准确度分别为:90.1%、94.6%、97.6%;两者联合与单独MDCT(P=0.0)或FDG PET/CT(P=0.021)的敏感度、两者联合与单独MDCT的特异度(P=0.007)、两者联合与单独MDCT(P=0.0)或FDG PET/CT(P=0.004)的准确度均有显著性差异。〖HTW〗结论〓〖HTK〗MDCT增强扫描与FDG PET/CT联合应用可克服各自缺点,提高对食管癌诊断及分期的准确性。

关键词: 食管肿瘤,分期, 体层摄影术,发射型计算机, 脱氧葡萄糖, 体层摄影术,X线计算机

Abstract:

Objective  To investigate the clinical effect of contrast-enhanced multiple-detector spiral computed tomography (MDCT) in combination with FDG PET/CT on esophageal cancer staging.  Methods  MDCT and FDG PET/CT were performed and prospectively interpreted in 79 patients with newly diagnosed esophageal cancer within one week. Primary lesions,invasion of adjacent structures, locations and numbers of metastases to the individual lymph node groups were observed. All the lesions were histopathologically confirmed. Results of MDCT, PET/CT and their combination were compared with histopathological results.  Results  Lesion detective rate was 78.3% by MDCT, 96.4%by PET/CT, and 96.4% by their combination. Sensitivity, specificity and accuracy for T4 staging tumors was 70.0%, 94.5% and 91.6% by MDCT, 90%, 68.5% and 71.1% by PET/CT, 90%, 98.6% and 97.6% by their combination. Differences in specificity(P=0.0) andaccuracy(P=0.0) between PET/CT alone and MDCT in combination with PET/CT were statistically  significant. For detecting lymph nodes metastases, the sensitivity, specificity and accuracy by MDCT was 70.5%, 95.9%, and 90.1%, and by FDG PET/CT was 86.1%, 97.1%, and 94.6%,whereas by their combination was 94.3%, 98.6%, and 97.6%. Differences in sensitivity (P=0.0), specificity(P=0.007) and accuracy(P=0.0)between MDCT alone and MDCT in combination with PET/CT were significant, also differences in sensitivity(P=0.021) and accuracy(P=0.004)between PET/CT alone and MDCT in combination with PET/CT were obviously significant.  Conclusion Diagnosis and staging of oesophageal cancer can be improved by using both FDG PET/CT and MDCT at the same time.

Key words: Esophageal Neoplasms, staging; Tomography, Emission-computed; Deoxyglucose; Tomography, X-ray computed

中图分类号: 

  • R814.42
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