山东大学学报(医学版) ›› 2016, Vol. 54 ›› Issue (4): 68-73.doi: 10.6040/j.issn.1671-7554.0.2015.1011
孙旭怡,韩建奎
SUN Xuyi, HAN Jiankui
摘要: 目的 评价PET/CT双时相显像对胰腺良恶性病变鉴别诊断的应用价值。 方法 对81例胰腺恶性病变和41例胰腺良性病变行18F-FDG PET/CT常规显像,其中46例胰腺恶性病变和22例胰腺良性病变行PET/CT延迟显像。寻求早期最大标准摄取值(SUV早期)和滞留指数(RI)的最佳诊断界值。 结果 胰腺恶性病变组SUV早期(5.46±3.51)明显高于良性病变组SUV早期(1.89±1.28)(P<0.05),胰腺恶性病变组SUV延迟(5.87±3.79)高于良性病变组SUV延迟(2.64±1.94)(P<0.05)。其中68例行PET/CT双时相显像的胰腺病变患者中,胰腺良性病变组SUV早期(2.33±1.25)和SUV延迟(2.64±1.94)差异无统计学意义(P>0.05);胰腺恶性病变组SUV早期(4.52±2.98)和SUV延迟(5.87±3.79)差异有统计学意义(P<0.05)。根据ROC曲线,以SUV早期=2.75为本研究的最佳诊断界值,灵敏度、特异度和准确度分别为82.72%、80.49%和81.97%;以RI%=12.04%为界值,灵敏度、特异度和准确度分别为82.61%、72.72%和79.41%;以SUV早期=2.75和RI%=12.04%为联合诊断标准,灵敏度、特异度和准确度分别为93.48%、59.10%和82.35%。 结论 18F-FDG PET/CT双时相显像对胰腺良恶性病变有良好的鉴别诊断价值。
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[1] Wang XL, Yang F, Jin C, et al. Utility of PET/CT in diagnosis, staging, assessment of resectability and metabolic response of pancreatic cancer[J]. World J Gastroenterol, 2014, 20(42): 15580-15589. [2] Bipat S, Phoa SS, van Delden OM, et al. Ultrasonography, computed tomography and magnetic resonance imaging for diagnosis and determining resectability of pancreatic adenocarcinoma: a meta-analysis[J]. J Comput Assist Tomogr, 2005, 29(4): 438-445. [3] Tang S, Huang G, Liu J, et al. Usefulness of 18F-FDG PET, combined FDG-PET/CT and EUS in diagnosing primary pancreatic carcinoma: A meta-analysis[J]. European Journal of Radiology, 2011, 78(1): 142-150. [4] Lodge MA, Lucas JD, Marsden PK, et al. A PET study of 18FDG uptake in soft tissue masses[J]. Eur J Nucl Med, 1999, 26(1): 22-30. [5] Kawada N, Uehara H, Hosoki T, et al. Usefulness of Dual-Phase 18F-FDG PET/CT for Diagnosing Small Pancreatic Tumors[J]. Pancreas, 2015, 44(4): 655-659. [6] Nakamoto Y, Higashi T, Sakahara H, et al. Delayed(18)F-fluoro-2-deoxy-D-glucose positron emission tomography scan for differentiation between malignant and benign lesions in the pancreas[J]. Cancer, 2000, 89(12): 2547-2554. [7] Rijkers AP, Valkema BR, Duivenvoorden HJ, et al. Usefulness of F-18-fluorodeoxyglucose positron emission tomography to confirm suspected pancreatic cancer: A meta-analysis[J]. Eur J Surg Oncol, 2014, 40(7): 794-804. [8] Nishiyama Y, Yamamoto Y, Monden T, et al. Evaluation of delayed additional FDG PET imaging in patients with pancreatic tumour[J]. Nucl Med Commun, 2005, 26(10): 895-901. [9] Yoshioka M, Uchinami H, Watanabe G, et al. F-18 fluorodeoxyglucose positron emission tomography for differential diagnosis of pancreatic tumors[J]. Springerplus, 2015, 4: 154. [10] Friess H, Langhans J, Ebert M, et al. Diagnosis of pancreatic cancer by 2[18F] -fluoro-2-deoxy-D-glucose positron emission tomograpgy[J]. Gut, 1995, 36(5): 771-777. [11] Delbeke D, Martin WH. PET and PET/CT for pancreatic malignancies[J]. Surg Oncol Clin N Am, 2010, 19(2): 235-254. [12] Ozaki Y, Oguchi K, Hamano H, et al. Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography[J]. Gastroenterol, 2008, 43(2): 144-151. [13] Kamisawa T, Takum K, Anjiki H, et al. FDG-PET/CT findings of autoimmune pancreatitis[J]. Hepatogastroenterology, 2010, 57(99-100): 447-450. [14] Shigekawa M, Yamao K, Sawaki A, et a1. Is 18F-fluorodeoxyglueose positron emission tomography meaningful for estimating the efficacy of corticosteroid therapy in patients with autoimmune pancreatitis?[J]. J Hepatobiliary Pancreat Sci, 2010, 17(3): 269-274. [15] Zimny M, Bares R, Fass J, et al. Fluorine-18 fluorodeoxyglucose positron emission tomography in the differential diagnosis of pancreatic carcinoma: a report of 106 cases[J]. Eur J Nucl Med, 1997, 24(6): 678-682. [16] von Forstner C, Egberts JH, Ammerpohl O, et al. Gene expression patterns and tumor uptake of 18F-FDG, 18F-FLT, and 18F-FEC in PET/MRI of an orthotopic mouse xenotransplantation model of pancreatic cancer[J]. J Nucl Med, 2008, 49(8): 1362-1370. |
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