CAJ | 학술논문

目的探讨18F-FDG PET/CT显像在诊断原发性腹膜乳头状浆液性癌(PPPSC)中的价值.方法回顾性分析2009年3月至2011年10月在PET/CT中心检查并经病理确诊的10例绝经期女性PPPSC患者,年龄61～81(69.4±6.2)岁.患者均行18F-FDG PET/CT显像,分析其病灶CT表现及PET的SUVmax,观察PPPSC的PET/CT表现,并与病理结果进行对比分析,同时测定PET/CT检查前或后1周内患者血清CA125,采用直线相关分析,评估壁腹膜、大网膜、肠系膜三者中最大的SUVmax与CA125的相关性.结果 10例PPPSC患者i8F-FDG PET/CT显像主要表现为:10例患者大网膜呈絮状、多发结节状及饼状软组织密度不均匀增高及代谢增强(SUVmax为6.32±2.87)；9例壁腹膜及8例肠系膜呈弥漫性或局限性结节状或条状软组织不均匀增厚及代谢增强(SUVmax分别为5.96±2.14和5.70±1.69),其中壁腹膜以盆壁腹膜受累为主,肠系膜以小肠系膜受累为主；10例患者均有不同程度的腹腔积液,以肝周及盆腔为主；2例双侧卵巢及1例右侧卵巢稍增大,最大直径均在5 cm以内,同时伴有代谢异常增高；4例腹膜后淋巴结转移；出现点状钙化灶、有少量胸腔积液、有肝脏转移、伴有肝门淋巴结转移各2例.所有患者CA125均增高[(51.25±26.40)×104 U/L],CA125与壁腹膜、大网膜及肠系膜三者中最大SUVmax无明显相关性(r=0.05,P＞0.05).结论 PET/CT显像可显示PPPSC病灶部位,也能反映病灶的代谢状态,可用于PPPSC的辅助诊断.
목적 탐토18F-FDG PET/CT현상재진단원발성복막유두상장액성암(PPPSC)중적개치.방법 회고성분석2009년3월지2011년10월재PET/CT중심검사병경병리학진적10례절경기녀성PPPSC환자,년령61～81(69.4±6.2)세.환자균행18F-FDG PET/CT현상,분석기병조CT표현급PET적SUVmax,관찰PPPSC적PET/CT표현,병여병리결과진행대비분석,동시측정PET/CT검사전혹후1주내환자혈청CA125,채용직선상관분석,평고벽복막、대망막、장계막삼자중최대적SUVmax여CA125적상관성.결과 10례PPPSC환자i8F-FDG PET/CT현상주요표현위:10례환자대망막정서상、다발결절상급병상연조직밀도불균균증고급대사증강(SUVmax위6.32±2.87)；9례벽복막급8례장계막정미만성혹국한성결절상혹조상연조직불균균증후급대사증강(SUVmax분별위5.96±2.14화5.70±1.69),기중벽복막이분벽복막수루위주,장계막이소장계막수루위주；10례환자균유불동정도적복강적액,이간주급분강위주；2례쌍측란소급1례우측란소초증대,최대직경균재5 cm이내,동시반유대사이상증고；4례복막후림파결전이；출현점상개화조、유소량흉강적액、유간장전이、반유간문림파결전이각2례.소유환자CA125균증고[(51.25±26.40)×104 U/L],CA125여벽복막、대망막급장계막삼자중최대SUVmax무명현상관성(r=0.05,P＞0.05).결론 PET/CT현상가현시PPPSC병조부위,야능반영병조적대사상태,가용우PPPSC적보조진단.
Objective To explore the diagnostic value of 18F-FDG PET/CT in primary peritoneal papillary serous carcinoma (PPPSC).Methods Ten postmenopausal female cases of pathologically diagnosed PPPSC from March 2009 to October 2011 were retrospectively reviewed (age range:61-81 years,mean:(69.4±6.2) years).All cases underwent 18F-FDG PET/CT.The CT characteristics and SUVmax of lesions on PET images were analyzed.Serum CA125 levels were measured before or after PET/CT within one week.The patterns of PPPSC on PET/CT were compared with histopathological results.Linear correlation analysis was used to evaluate the correlation between the CA125 and the maximum SUVmax of lesions presented in parietal peritoneum,greater omentum or mesentery.Results The PET/CT uptake pattern of the 10 PPPSC cases was described as floccus,multi-nodular or cake-like in greater omentum (SUVmax =6.32±2.87),and as diffuse or localized nodules,or non-uniform strip-like thickening in 9 parietal peritoneum and 8 mesentery cases (SUVmax =5.96±2.14 and 5.70± 1.69,respectively).The most commonly involved sites were pelvic wall of peritoneum and mesentery of small intestine.All 10 cases had different degrees of ascites,mainly intrapelvic and perihepatic.Hypermetabolic ovarian enlargement (all ＜5 cm) was bilateral in 2 patients and right-sided in 1 patient.Four patients had retroperitoneal lymph node metastasis and others were found with punctate calcifications in metastatic lymph nodes,small pleural effusions,liver metastasis,as well as portal node metastasis.CA125 concentration was elevated in all cases ((51.25±26.40) ×104 U/L),but there was no significant correlation between CA125 and the maximum SUVmax of lesions found in parietal peritoneum,greater omentum or mesentery (r=0.05,P＞0.05).Conclusion 18F-FDG PET/CT could show the positions and metabolic status of PPPSC lesions.It may be an effective imaging modality in the diagnosis and assessment of PPPSC.