中国基层医药
中國基層醫藥
중국기층의약
CHINESE JOURNAL OF PRIMARY MEDICINE AND PHARMACY
2012年
2期
195-198
,共4页
谢昌辉%尹吉林%李向东%王欣璐%李兴耀
謝昌輝%尹吉林%李嚮東%王訢璐%李興耀
사창휘%윤길림%리향동%왕흔로%리흥요
小肠肿瘤%体层摄影术,发射型计算机%脱氧葡萄糖%病理学
小腸腫瘤%體層攝影術,髮射型計算機%脫氧葡萄糖%病理學
소장종류%체층섭영술,발사형계산궤%탈양포도당%병이학
Small intestine neoplasms%Tomography-emission-computed%Deoxyglucose%Pathology
目的 探讨原发性小肠恶性肿瘤不同病理条件下的18F-双脱氧葡萄糖(FDG)PET/CT全身显像征象.方法 回顾分析44例原发性小肠疾病患者(恶性25例,良性19例)的18 F-FDGPET/CT显像资料,结果 经组织学、诊断性治疗和/或临床随访证实；采用目测法、定量方法(测病变肠壁的厚度)及半定量方法测量病灶的最大标准摄取值(SUVmax)及肠壁厚度,总结分析不同病理条件下的PET/CT的影像特点.结果(1)原发性小肠良、恶性病变局部肿块形成分别为31.6％、84.0％(x2=10.4,P＜0.01)；肠壁厚度分别为(0.75±0.32)cm、(1.42±0.20)cm(t =2.66,P＜0.01)；SUVmax分别为(5.17±3.04)、(9.65±5.48)(t =2.88,P＜0.01)；灶周淋巴结肿大的发生率分别为52.6％、72.0％(x2=1.01,P＞0.05),SUVmax分别为(4.80±1.91)、(7.00±5.61)(t=1.11,P＞0.05).(2)原发性小肠恶性肿瘤的其他脏器转移发生率为44.0％(11/25),以肝(28.0％)、远处淋巴结(20.0％)和骨转移(16.0％)最为多见；最多病理类型为恶性淋巴瘤(44.0％),其次为腺癌(32.0％),两者的肠壁厚度分别为(1.41±0.59)cm、(1.36±0.62)cm(t =0.18,P＞0.05)；SUVmax分别为(12.49±7.00)、(7.93±2.82)(t =7.55,P＜0.01)；转移发生率分别为9.1％、62.5％(x2 =3.89,P＜0.05).(3)以小肠局部肿块形成、SUVmax=4.20、局部肠壁增厚和/或转移为依据,18F-FDGPET/CT显像诊断小肠原发恶性肿瘤的灵敏度、特异性和准确度分别为96.0％、94.7％和95.4％；假阳性主要为肠结核,假阴性为印戒细胞癌.结论 18F-FDGPET/CT显像对原发性小肠恶性肿瘤具有较高的鉴别诊断价值,灶周淋巴结大小及其SUVmax值不能提示其良恶性,原发性小肠淋巴瘤的18F-FDG摄取明显高于腺癌,两者的肠壁厚度无显著差异.
目的 探討原髮性小腸噁性腫瘤不同病理條件下的18F-雙脫氧葡萄糖(FDG)PET/CT全身顯像徵象.方法 迴顧分析44例原髮性小腸疾病患者(噁性25例,良性19例)的18 F-FDGPET/CT顯像資料,結果 經組織學、診斷性治療和/或臨床隨訪證實；採用目測法、定量方法(測病變腸壁的厚度)及半定量方法測量病竈的最大標準攝取值(SUVmax)及腸壁厚度,總結分析不同病理條件下的PET/CT的影像特點.結果(1)原髮性小腸良、噁性病變跼部腫塊形成分彆為31.6％、84.0％(x2=10.4,P＜0.01)；腸壁厚度分彆為(0.75±0.32)cm、(1.42±0.20)cm(t =2.66,P＜0.01)；SUVmax分彆為(5.17±3.04)、(9.65±5.48)(t =2.88,P＜0.01)；竈週淋巴結腫大的髮生率分彆為52.6％、72.0％(x2=1.01,P＞0.05),SUVmax分彆為(4.80±1.91)、(7.00±5.61)(t=1.11,P＞0.05).(2)原髮性小腸噁性腫瘤的其他髒器轉移髮生率為44.0％(11/25),以肝(28.0％)、遠處淋巴結(20.0％)和骨轉移(16.0％)最為多見；最多病理類型為噁性淋巴瘤(44.0％),其次為腺癌(32.0％),兩者的腸壁厚度分彆為(1.41±0.59)cm、(1.36±0.62)cm(t =0.18,P＞0.05)；SUVmax分彆為(12.49±7.00)、(7.93±2.82)(t =7.55,P＜0.01)；轉移髮生率分彆為9.1％、62.5％(x2 =3.89,P＜0.05).(3)以小腸跼部腫塊形成、SUVmax=4.20、跼部腸壁增厚和/或轉移為依據,18F-FDGPET/CT顯像診斷小腸原髮噁性腫瘤的靈敏度、特異性和準確度分彆為96.0％、94.7％和95.4％；假暘性主要為腸結覈,假陰性為印戒細胞癌.結論 18F-FDGPET/CT顯像對原髮性小腸噁性腫瘤具有較高的鑒彆診斷價值,竈週淋巴結大小及其SUVmax值不能提示其良噁性,原髮性小腸淋巴瘤的18F-FDG攝取明顯高于腺癌,兩者的腸壁厚度無顯著差異.
목적 탐토원발성소장악성종류불동병리조건하적18F-쌍탈양포도당(FDG)PET/CT전신현상정상.방법 회고분석44례원발성소장질병환자(악성25례,량성19례)적18 F-FDGPET/CT현상자료,결과 경조직학、진단성치료화/혹림상수방증실；채용목측법、정량방법(측병변장벽적후도)급반정량방법측량병조적최대표준섭취치(SUVmax)급장벽후도,총결분석불동병리조건하적PET/CT적영상특점.결과(1)원발성소장량、악성병변국부종괴형성분별위31.6％、84.0％(x2=10.4,P＜0.01)；장벽후도분별위(0.75±0.32)cm、(1.42±0.20)cm(t =2.66,P＜0.01)；SUVmax분별위(5.17±3.04)、(9.65±5.48)(t =2.88,P＜0.01)；조주림파결종대적발생솔분별위52.6％、72.0％(x2=1.01,P＞0.05),SUVmax분별위(4.80±1.91)、(7.00±5.61)(t=1.11,P＞0.05).(2)원발성소장악성종류적기타장기전이발생솔위44.0％(11/25),이간(28.0％)、원처림파결(20.0％)화골전이(16.0％)최위다견；최다병리류형위악성림파류(44.0％),기차위선암(32.0％),량자적장벽후도분별위(1.41±0.59)cm、(1.36±0.62)cm(t =0.18,P＞0.05)；SUVmax분별위(12.49±7.00)、(7.93±2.82)(t =7.55,P＜0.01)；전이발생솔분별위9.1％、62.5％(x2 =3.89,P＜0.05).(3)이소장국부종괴형성、SUVmax=4.20、국부장벽증후화/혹전이위의거,18F-FDGPET/CT현상진단소장원발악성종류적령민도、특이성화준학도분별위96.0％、94.7％화95.4％；가양성주요위장결핵,가음성위인계세포암.결론 18F-FDGPET/CT현상대원발성소장악성종류구유교고적감별진단개치,조주림파결대소급기SUVmax치불능제시기량악성,원발성소장림파류적18F-FDG섭취명현고우선암,량자적장벽후도무현저차이.
Objective To study the relationship between the 18F-FDG PET/CT whole body imaging characteristics and pathologic features of small intestine primary malignant neoplasms.Methods A retrospective study was carried out on 18F-FDG PET/CT data of patients(n =44)with small intestine disease(25 malignant,19 benign).All results were proved by pathologiy,or diagnostic therapy and/or clinical follow-up.The intestinal wall thickness(IWT)and maxium standardized uptake value(SUVmax)were used to analyze the imaging features under different pathological conditions.Results(1)The incidence rate of local tumor formation for benign and malignant intestinal lesions was 31.6％ and 84.0％(x2 =10.40,P ＜ 0.01),respectively.The IWT was(0.75 ± 0.32)cm and(1.42 ± 0.20)cm(t =2.66,P ＜ 0.01),respectively.The S UVmax was(5.17 ± 3.04)and(9.65 ± 5.48)(t =2.88,P ＜ 0.01),respectively.The incidence rate of enlargement of mesenteric lymph nodes for benign and malignant intestinal lesions was 52.6％ and 72.0％(x2 =1.01,P ＞ 0.05),respectively.The SUVmax was(4.80 ± 1.91)and(7.00 ± 5.61)(t =1.11,P ＞ 0.05),respectively.(2)The metastasis incidence rate of other organs for intestinal malignant lesions was 44.0％.The most common metastasis organs were liver(28.0％),distant lymph nodes(20.0％)and bone (16.0％).The most pathological type of intestinal malignant lesions were malignant lymphoma(44.0％),adenocarcinoma(32.0％).The IWT was(1.41 ± 0.59)cm and(1.36 ± 0.62)cm(t =0.18,P ＞ 0.05),respectively.The SUVmax was(12.49 ± 7.00)and(7.93 ± 2.82)(t =7.55,P ＜ 0.01),respectively.The metastasis incidence rate was 9.1％ and 62.5 ％(x2 =3.89,P ＜ 0.05),respectively.(3)Taking the intestinal local tumor formation and SUVmax andnot less than 4.2 0 wall thickening,and / or metastasis as the main basis of the intestinal malignant lesions,the sensitivity,specificity and accuracy were 96.0％,94.7％ and 95.4％,respectively.The main pathological type of false positive for '8F-FDG PET/CT imaging was intestinal tuberculosis,and false negative was signet(f)ing cell carcinoma.Conclusion 18F-FDG PET/CT imaging has a higher clinical diagnosis value in differentiating small intestine primary malignant carcinoma from benign ones.The size and SUVmax of perifocus lymph nodes could not point out its malignant degree.The 18F-FDG uptake of the lesions is correlated with pathological type.The IWT is not correlated with pathological type.
