CAJ | 학술논문

目的研究偶发垂体大腺瘤在健康人群及肿瘤患者间发病率的差异,并探讨18F-FDGPET/CT全身显像在偶发垂体大腺瘤诊断中的临床意义.方法对行PET/CT头部及体部检查的无垂体瘤相关病史的1830例患者进行回顾性分析,其中健康体检者600例,确诊及疑诊肿瘤患者1230例；选择PET显示垂体部位高摄取及同机CT显示垂体占位(病灶短径大于1.0 cm)患者,记录病灶最大标准化摄取值(SUVmax)；对入选患者进行随访3 ～26个月,经病理及MRI明确最终诊断；所有结果采用SPSS16.0软件进行统计学分析,应用Fisher确切检验比较偶发垂体大腺瘤在两组人群间发病率的差异,并评价PET/CT对偶发垂体大腺瘤的诊断价值.结果 15例患者符合上述标准入选,SUVmax为4.2～22.2;1例患者经手术确诊为垂体区转移瘤,SUVmax为19.5; 14例患者为偶发垂体大腺瘤,发病率为0.77％,其中源于健康体检者1例,发病率为0.17％,其余13例患者均具有恶性肿瘤病史,发病率为1.06％; PET/CT对偶发垂体大腺瘤的检出率为100％,准确率为93.33％.结论恶性肿瘤患者组垂体大腺瘤的发病率高于健康体检组；18F-FDG PET/CT显像对偶发垂体大腺瘤具有较高的诊断价值.
목적 연구우발수체대선류재건강인군급종류환자간발병솔적차이,병탐토18F-FDGPET/CT전신현상재우발수체대선류진단중적림상의의.방법 대행PET/CT두부급체부검사적무수체류상관병사적1830례환자진행회고성분석,기중건강체검자600례,학진급의진종류환자1230례；선택PET현시수체부위고섭취급동궤CT현시수체점위(병조단경대우1.0 cm)환자,기록병조최대표준화섭취치(SUVmax)；대입선환자진행수방3 ～26개월,경병리급MRI명학최종진단；소유결과채용SPSS16.0연건진행통계학분석,응용Fisher학절검험비교우발수체대선류재량조인군간발병솔적차이,병평개PET/CT대우발수체대선류적진단개치.결과 15례환자부합상술표준입선,SUVmax위4.2～22.2;1례환자경수술학진위수체구전이류,SUVmax위19.5; 14례환자위우발수체대선류,발병솔위0.77％,기중원우건강체검자1례,발병솔위0.17％,기여13례환자균구유악성종류병사,발병솔위1.06％; PET/CT대우발수체대선류적검출솔위100％,준학솔위93.33％.결론 악성종류환자조수체대선류적발병솔고우건강체검조；18F-FDG PET/CT현상대우발수체대선류구유교고적진단개치.
Objective To study the incidence difference between healthy people and patients with malignant tumor,and to discuss the diagnostic value of whole-body 18F-FDG PET/CT examination on incidental pituitary macroadenomas.Methods A review analysis was made about the image data of 1830 consecutive subjects with no history of pituitary tumor,including 600 healthy subjects and 1230 patients with known or suspected malignancy who underwent 18F-FDG PET/CT examination.The uptake intensity was recorded by maximum standardized uptake value (SUVmax) of those unexpected pituitary tumor (shot diameter greater than 1.0 cm) with high uptake.The final diagnosis was based on pathology and a 3-26 months follow-up.Compared the incidence difference between healthy people and patients with malignant tumor by Fisher exact test (SPSS 16.0).Assessed the diagnostic efficacy of PET/CT examination.Results Pituitary tumor was accidentally discovered in 15 patients (SUVmax varied between 4.2 and 22.2),including 1 metastases SUVmax 19.5 and 14 (0.77％) pituitary macroadenomas; the incidence rate 0.17％ (only 1 case was confirmed of pituitary macroadenomas) among the healthy subjects is higher than that of 1.06％ (13 cases) among the malignant tumor patients.The sensitivity and accuracy of PET/CT in detecting large pituitary adenomas were 100％ and 93.33％ respectively.Conclusions The incidence of pituitary macroadenoma is higher in patients with raligant tumor than that in the healthy controls.PET/CT is of practical significance in the diagnosis of the pituitary macroadenomas.