CAJ | 학술논문

目的探讨18氟-脱氧葡萄糖正电子发射计算机断层成像术(18F-FDG PET-CT)全身显像检查中意外发现的结直肠局限性高代谢灶摄取程度及其功能-解剖形态特征对其良恶性病变鉴别诊断的价值.方法回顾性分析2010年1月至2012年2月间在解放军第一一三医院进行PET-CT显像时意外发现结直肠局部高代谢灶的37例患者的临床和影像学资料,根据最终的临床诊断(9例经手术及术后病理证实,15例经肠镜检查证实,13例经临床随访明确)分为恶性病变、良性占位病变(包括癌前病变)、炎性病变和生理性摄取4组,对局部高代谢灶的放射性摄取程度(病灶最大标准摄取值,SUVmax)和延迟显像的变化(滞留指数,RI)进行组间比较,采用方差分析进行数据处理.结果 37例病灶中,恶性病变11例、良性占位性病变9例,炎性病变9例,生理性摄取8例,其SUVmax分别为6.3±3.7、8.8±6.5、5.2±1.4和3.8±0.9,RI分别为0.3±0.2、0.4±0.1、0.3±0.2、0.4±0.2.肿瘤组(良性和恶性)SUVmax为7.6±5.6,明显高于非肿瘤组(炎性和生理性摄取)的4.7±1.5(P＜0.05)；但良性、恶性肿瘤间及炎性与生理性摄取间SUVmax的差异均无统计学意义(P＞0.05).4组病灶RI的差异也无统计学意义(P＞0.05).结论在PET显像中,通过意外发现的结直肠局限性FDG高代谢灶可以探查到一些潜在的早期结直肠的恶性肿瘤或癌前病变.这些高代谢灶的SUVmax值对肿瘤与炎性和生理性摄取的鉴别有诊断价值,但对良、恶性病变的鉴别无意义.
목적 탐토18불-탈양포도당정전자발사계산궤단층성상술(18F-FDG PET-CT)전신현상검사중의외발현적결직장국한성고대사조섭취정도급기공능-해부형태특정대기량악성병변감별진단적개치.방법 회고성분석2010년1월지2012년2월간재해방군제일일삼의원진행PET-CT현상시의외발현결직장국부고대사조적37례환자적림상화영상학자료,근거최종적림상진단(9례경수술급술후병리증실,15례경장경검사증실,13례경림상수방명학)분위악성병변、량성점위병변(포괄암전병변)、염성병변화생이성섭취4조,대국부고대사조적방사성섭취정도(병조최대표준섭취치,SUVmax)화연지현상적변화(체류지수,RI)진행조간비교,채용방차분석진행수거처리.결과 37례병조중,악성병변11례、량성점위성병변9례,염성병변9례,생이성섭취8례,기SUVmax분별위6.3±3.7、8.8±6.5、5.2±1.4화3.8±0.9,RI분별위0.3±0.2、0.4±0.1、0.3±0.2、0.4±0.2.종류조(량성화악성)SUVmax위7.6±5.6,명현고우비종류조(염성화생이성섭취)적4.7±1.5(P＜0.05)；단량성、악성종류간급염성여생이성섭취간SUVmax적차이균무통계학의의(P＞0.05).4조병조RI적차이야무통계학의의(P＞0.05).결론 재PET현상중,통과의외발현적결직장국한성FDG고대사조가이탐사도일사잠재적조기결직장적악성종류혹암전병변.저사고대사조적SUVmax치대종류여염성화생이성섭취적감별유진단개치,단대량、악성병변적감별무의의.
Objective To investigate the value of incidental focal 18F-FDG uptake in the colon and rectum and characteristics of functional anatomic form for differential diagnosis of colorectal benign or malignant diseases.Methods Clinical data and images of incidental focal hypermetabolism focus in colon and rectum of 37 individuals undergoing 18F-FDG PET-CT were analyzed retrospectively.According to the eventual outcomes of pathological examination and clinical follow-up,these cases were divided into four subgroups:malignant disease,benign tumor (including precancerous change),inflammation and physiological uptake.Radioactive uptake level (SUVmax)and change of delayed imaging (RI) of focal hypermetabolism focus were compared between groups.The data analysis was performed using variance analysis.Results The average SUVmax was 6.3±3.7,8.8±6.5,5.2±1.4,and 3.8±0.9 in malignant disease(n=11),benign(precancerous) tumor(n=9),inflammation(n=9) and physiological uptaking (n=8) respectively.The average SUVmax was 7.6±5.6 in benign and malignant tumor,and 4.7±1.5 in inflammation and physiological uptake.The distinction of average SUVmax was not statistically significant between benign and malignant tumor or inflammation and physiological uptake.But it was higher in tumors as compared to inflammation or physiological uptake with a statistically difference (P＜0.05).The RI was 0.3±0.2,0.4±0.1,0.3±0.2,0.4±0.2 in above 4 groups respectively,and the differences were not statistically significant.Conclusions The incidental focal hypermetabolism focus in the colon the rectum during 18F-FDG PET-CT may indicate potential colorectal malignant diseases and precancerous lesions.SUVmax value in focal hypermetabolism focus in the colon and rectum can help to distinguish tumor from inflammation or physiological uptake.But there is no diagnostic value for distinguishing malignant disease from benign tumor.