CAJ | 학술논문

目的探讨18 F-FDG符合线路显像在胃肠间质瘤(GIST)良恶性鉴别及其治疗后复发监测的价值.方法回顾性分析22例经免疫组织化学证实为GIST患者,共行28例次18F-FDG符合线路显像.13例术前显像,9例术后显像,9例中2例临床予药物治疗过程中分别行4次显像.用ROI技术计算良恶性病变/正常组织放射性比值(T/B).术前良恶性病例组间T/B比较采用两样本比较t检验,并将T/B与GIST危险度分级进行等级相关分析.结果 13例术前显像呈高摄取者10例(T/B＞2.0),低摄取3例(T/B≤2.0)；病理检查证实:18F-FDG高摄取10例均为恶性(高度或中度危险),低摄取良性3例(极低或低危险度).恶性组患者T/B为5.050±2.315,与良性患者的1.533±0.503相比,差异有统计学意义(t=4.464,P＜0.001)；T/B与GIST危险度分级间存在相关性(r=0.819,P＜0.01);9例术后显像者复发或转移5例,FDG均呈高摄取,T/B均＞2.2.结论 18F-FDG符合线路显像在原发GIST良恶性的鉴别及治疗后复发或转移灶的监测中有一定应用价值.
목적 탐토18 F-FDG부합선로현상재위장간질류(GIST)량악성감별급기치료후복발감측적개치.방법 회고성분석22례경면역조직화학증실위GIST환자,공행28례차18F-FDG부합선로현상.13례술전현상,9례술후현상,9례중2례림상여약물치료과정중분별행4차현상.용ROI기술계산량악성병변/정상조직방사성비치(T/B).술전량악성병례조간T/B비교채용량양본비교t검험,병장T/B여GIST위험도분급진행등급상관분석.결과 13례술전현상정고섭취자10례(T/B＞2.0),저섭취3례(T/B≤2.0)；병리검사증실:18F-FDG고섭취10례균위악성(고도혹중도위험),저섭취량성3례(겁저혹저위험도).악성조환자T/B위5.050±2.315,여량성환자적1.533±0.503상비,차이유통계학의의(t=4.464,P＜0.001)；T/B여GIST위험도분급간존재상관성(r=0.819,P＜0.01);9례술후현상자복발혹전이5례,FDG균정고섭취,T/B균＞2.2.결론 18F-FDG부합선로현상재원발GIST량악성적감별급치료후복발혹전이조적감측중유일정응용개치.
Objective To explore the value of 18F-FDG coincidence imaging for the differentiation of benign from malignant gastrointestinal stromal tumors (GIST) and identifying post-therapeutic recurrence.Methods Twenty-two cases with pathologically confirmed GIST were retrospectively analyzed.There were a total of 28 18F-FDG coincidence imaging scans,including 13 patients with preoperative scans and 9 patients with postoperative scans (2 patients with an extra 3 scans during the treatment).ROIs were drawn over the tumor (T) and contralateral/adjacent normal tissue (B).The ratios of T/B were calculated and compared by t-test.The correlation between the ratio of T/B and the risk ranking of GIST was analyzed.Results Among the 13 patients with preoperative scans,10 patients with high FDG uptake (T/B ＞2.0)were confirmed as malignant by pathology and ranked as high/intermediate risk; the others with low FDG uptake (T/B≤2.0) were confirmed as benign and ranked as low/extremely low risk.There was significant difference between the T/B ratios of the malignant (5.050 ± 2.315 ) and benign ( 1.533 ± 0.503 ) lesions (t =4.464,P ＜ 0.001 ).There was significant correlation between the T/B ratio and risk ranking of GIST (r =0.819,P ＜ 0.01 ).Among the 9 patients with postoperative scans,recurrence or metastasis was found in 5 patients (T/B ratio ＞ 2.2).Conclusion 18F-FDG coincidence imaging is valuable for the differentiation of benign from malignant GIST and for monitoring recurrence/metastasis after treatment.