CAJ | 학술논문

目的评价PET-CT在胸腹膜转移瘤诊断中的临床价值.方法回顾性分析具有原发恶性肿瘤病史及不明原因胸腹腔积液,临床高度怀疑胸腹膜转移瘤的37例患者资料.全部患者均行18F-FDG PET-CT全身显像,经病历记录分析、肿瘤标志物检测、病理检查或临床随访最终判断是否存在胸腹膜转移瘤,并对已确诊胸腹膜转移瘤的患者记录病灶代谢分布形态及测量最大标准化摄取值(SUVmax).结果 37例行18F-FDG PET-CT全身显像的患者中,PET-CT诊断阳性的患者共29例,其中,假阳性3例；诊断为阴性的患者共8例,其中,假阴性2例.18F-FDG PET-CT全身显像诊断胸腹膜转移瘤的灵敏度为92.9％、特异度为66.7％、准确率为86.5％、阳性预测值为89.7％、阴性预测值为75％.在已确诊胸腹膜转移瘤的26例患者的全身显像中,病灶摄取形态呈条形或环形分布者11例、呈点灶状分布者15例,两组病灶SUVmax分别为5.97±3.39和2.89±0.92,差异具有统计学意义(t=2.93,P＜0.05).结论 PET-CT全身显像在胸腹膜转移瘤的诊断中具有简单、无创和灵敏度高等优点,是一种理想的判断胸腹膜转移瘤的方法,具有较高的临床应用价值.
목적 평개PET-CT재흉복막전이류진단중적림상개치.방법 회고성분석구유원발악성종류병사급불명원인흉복강적액,림상고도부의흉복막전이류적37례환자자료.전부환자균행18F-FDG PET-CT전신현상,경병력기록분석、종류표지물검측、병리검사혹림상수방최종판단시부존재흉복막전이류,병대이학진흉복막전이류적환자기록병조대사분포형태급측량최대표준화섭취치(SUVmax).결과 37례행18F-FDG PET-CT전신현상적환자중,PET-CT진단양성적환자공29례,기중,가양성3례；진단위음성적환자공8례,기중,가음성2례.18F-FDG PET-CT전신현상진단흉복막전이류적령민도위92.9％、특이도위66.7％、준학솔위86.5％、양성예측치위89.7％、음성예측치위75％.재이학진흉복막전이류적26례환자적전신현상중,병조섭취형태정조형혹배형분포자11례、정점조상분포자15례,량조병조SUVmax분별위5.97±3.39화2.89±0.92,차이구유통계학의의(t=2.93,P＜0.05).결론 PET-CT전신현상재흉복막전이류적진단중구유간단、무창화령민도고등우점,시일충이상적판단흉복막전이류적방법,구유교고적림상응용개치.
Objective To evaluate the clinical value of 18F-FDG PET-CT in diagnosis of the pleural or peritoneal carcinomatosis.Methods A total of 37 patients with pleural effusion or ascites of unknown origin were analyzed retrospectively.All patients underwent whole body 18F-FDG PET-CT.The 18F-FDG distributional pattern and the maximum standardized uptake value (SUVmax) of lesions were analyzed.The final diagnosis of all cases were established based on the results of catamnestic analysis,tumor markers assay,histopathology or clinical follow-up.Results Of all the 37 cases,29 had positive findings on 18F-FDG PET-CT,of which 26 were pleural or peritoneal carcinomatosis and 3 were pleural or peritoneal tuberculosis; 8patients had negative findings on 18F-FDG PET-CT,of which 6 were pleural or peritoneal benign lesions and 2 were peritoneal carcinomatosis.The sensitivity,specificity,accuracy,positive predictive value,negative predictive value of 18F-FDG PET-CT in diagnosis of peritoneal carcinomatosis were 92.9％,66.7％,86.5％,89.7％ and 75.0％ respectively.The SUVmax between the ring-form and strip-type lesions were significantly different(5.97±3.39 vs.2.89±0.92,t=2.93,P＜0.05).Conclusions 18F-FDG PET-CT is simple,noninvasive and high sensitive in detecting pleural or peritoneal carcinomatosis,and may be an ideal technique of highly clinical usefulness in the diagnosis of the pleural or peritoneal carcinomatosis.