CAJ | 학술논문

目的研究18F-FDG PET-CT对肾上腺转移性癌的诊断价值,并探讨其最佳诊断标准.方法对59例术后病理或临床随访确诊为肾上腺转移癌及18例肾上腺良性病变患者行18F-FDGPET-CT检查,分别测量肾上腺病灶的大小、SUVmax及正常肝组织的SUVmax,进行综合分析.结果 59例肾上腺转移癌患者共78个肾上腺病灶,SUVmax为7.05±5.26,18例良性病变患者共21个肾上腺病灶,SUVmax为2.27±1.35,两者之间的差异有统计学意义(t=7.199,P＜0.01)；肾上腺转移癌与良性病灶的大小(短径)分别为(1.52±1.05)cm和(1.66±0.91) cm,两者之间的差异无统计学意义(t=0.529,P＞0.05).受试者工作特征曲线分析,以肾上腺病灶SUVmax＞3.1作为良恶性的诊断标准,其诊断灵敏度、特异度和准确率分别为83.3％、90.5％和84.9％；以肾上腺病灶SUVmax与正常肝组织的SUVmax比值＞1作为良恶性诊断标准,则诊断的灵敏度、特异度、准确率分别为96.2％、90.5％和95.0％；肾上腺转移癌病灶大小(短径)与其SUVmax相关系数为0.501.肾上腺转移癌在双侧肾上腺的分布比例为:左侧30例(50.8％),右侧10例(17.0％),双侧19例(32.2％).结论 18FFDG PET-CT对于肾上腺转移瘤的诊断具有较高的灵敏度及准确率；以肾上腺病灶SUVmax与正常肝组织的SUVmax比值＞1为标准,可较好地诊断出肾上腺转移瘤的良恶性；肾上腺转移癌病灶的大小与其SUVmax有一定相关性,病灶常累及左侧.
목적 연구18F-FDG PET-CT대신상선전이성암적진단개치,병탐토기최가진단표준.방법 대59례술후병리혹림상수방학진위신상선전이암급18례신상선량성병변환자행18F-FDGPET-CT검사,분별측량신상선병조적대소、SUVmax급정상간조직적SUVmax,진행종합분석.결과 59례신상선전이암환자공78개신상선병조,SUVmax위7.05±5.26,18례량성병변환자공21개신상선병조,SUVmax위2.27±1.35,량자지간적차이유통계학의의(t=7.199,P＜0.01)；신상선전이암여량성병조적대소(단경)분별위(1.52±1.05)cm화(1.66±0.91) cm,량자지간적차이무통계학의의(t=0.529,P＞0.05).수시자공작특정곡선분석,이신상선병조SUVmax＞3.1작위량악성적진단표준,기진단령민도、특이도화준학솔분별위83.3％、90.5％화84.9％；이신상선병조SUVmax여정상간조직적SUVmax비치＞1작위량악성진단표준,칙진단적령민도、특이도、준학솔분별위96.2％、90.5％화95.0％；신상선전이암병조대소(단경)여기SUVmax상관계수위0.501.신상선전이암재쌍측신상선적분포비례위:좌측30례(50.8％),우측10례(17.0％),쌍측19례(32.2％).결론 18FFDG PET-CT대우신상선전이류적진단구유교고적령민도급준학솔；이신상선병조SUVmax여정상간조직적SUVmax비치＞1위표준,가교호지진단출신상선전이류적량악성；신상선전이암병조적대소여기SUVmax유일정상관성,병조상루급좌측.
Objective To investigate the value of 18F-FDG PET-CT in the diagnosis of the adrenal metastasis and study its diagnostic criteria.Methods Fifty-nine patients with adrenal metastasis and 18 patients with adrenal benign tumor underwent 18F-FDG PET-CT,all of the adrenal lesion's diameter and FDG maximum standardized uptake values (SUVmax),SUVmax of normal liver were measured and analyzed comprehensively.All lesions underwent biopsy after operation or follow-up in clinic or imaging diagnosis for final diagnosis.Results There were 78 adrenal lesions of 59 cases with adrenal metastasis,and 21 adrenal lesions of 18 cases with adrenal benign.The SUVmax of adrenals metastasis was 7.05 ±5.26,while benign tumor was 2.27±1.35,statistical significant difference was found between the 2 groups (t=7.199,P＜0.01 ).The short diameter of adrenal metastasis was ( 1.66±0.91 ) cm,benign tumor was ( 1.52±1.05 ) cm,there was no statistical significant difference between the 2 groups (t=0.529,P＞0.05 ).Receiver operator characteristic curve analysis showed that using lesion's SUVmax ＞3.1 as the diagnostic criteria of benign and metastatic adrenal lesions,the sensitivity,specificity and accuracy of 18F-FDG PET- CT in diagnosis of adrenals metastasis were 83.3％,90.5％ and 84.9％,respectively.But if using the SUVmax of adrenal lesion exceeds normal liver tissue as the diagnostic criteria,the sensitivity,specificity and accuracy were 96.2％,90.5％ and 95.0％.For adrenals metastasis,the correlation coefficient between lesion size (short diameter) and SUVmax was 0.501.Among all 59 cases with adrenal metastasis,30(50.8％) patients' lesions in the left adrenal gland,10(16.9％) in the right side and 19 (32.2％) in the both sides.Conclusion 18F-FDG PET-CT has high sensitivity andaccurate in diagnosis of adrenal metastasis,and the SUVmax of adrenal lesion exceeds normal liver tissue is a better diagnostic criteria.The size of adrenal metastasis lesions has certain correlation with its SUVmax and the lesions often in the left side gland and lung cancer is the more common primary tumor.