CAJ | 학술논문

目的探讨11C-乙酸盐(AC) PET早期血流灌注显像与常规显像联合应用(双时相显像)在肝原发肿瘤鉴别诊断中的作用.方法 40例[男34例,女6例;(55.4± 13.0)岁]肝占位患者均行11C-AC PET早期显像(注射AC后即刻行肝局部显像)及常规显像(注射后10～ 20 min行全身显像),分别计算病灶摄取比(R1、R2)及变化率(△R).以病理结果为“金标准”,计算和比较早期、常规及双时相显像方法的诊断效能.采用x2检验和直线相关分析分析数据.结果 40例中,恶性28例,良性12例.早期显像病灶对11C-AC摄取与动脉血液供应有关(x2=5.62,P＜0.01);R1与R2呈正相关(r=0.71,P＜0.01);3种方法诊断效能分析:早期、常规及双时相显像方法的ROC AUC分别为0.47、0.49和0.68;HCC病灶R1、R2、△R与恶性程度分级的r分别为-0.61、-0.75和-0.67,均P＜0.01.结论双时相显像方法可动态反映肿瘤动脉血液供应及代谢异常变化,结合△R定量指标,对肝原发肿瘤的良恶性鉴别诊断有一定帮助.
목적 탐토11C-을산염(AC) PET조기혈류관주현상여상규현상연합응용(쌍시상현상)재간원발종류감별진단중적작용.방법 40례[남34례,녀6례;(55.4± 13.0)세]간점위환자균행11C-AC PET조기현상(주사AC후즉각행간국부현상)급상규현상(주사후10～ 20 min행전신현상),분별계산병조섭취비(R1、R2)급변화솔(△R).이병리결과위“금표준”,계산화비교조기、상규급쌍시상현상방법적진단효능.채용x2검험화직선상관분석분석수거.결과 40례중,악성28례,량성12례.조기현상병조대11C-AC섭취여동맥혈액공응유관(x2=5.62,P＜0.01);R1여R2정정상관(r=0.71,P＜0.01);3충방법진단효능분석:조기、상규급쌍시상현상방법적ROC AUC분별위0.47、0.49화0.68;HCC병조R1、R2、△R여악성정도분급적r분별위-0.61、-0.75화-0.67,균P＜0.01.결론 쌍시상현상방법가동태반영종류동맥혈액공응급대사이상변화,결합△R정량지표,대간원발종류적량악성감별진단유일정방조.
Objective To investigate the application of early and routine dual-phase 11 C-acetate (AC) PET in detection of primary hepatoma.Methods Forty patients (34 males,6 females; (55.4± 13.0) years) with hepatic mass were included in the study.Each patient underwent dual-phase 11C-AC PET/CT scan.The early upper-abdomen scan was performed immediately after injection of 11C-AC,following a routine whole body scan 10-20 min after injection.The retention of 11C-AC in hepatic mass were calculated as T/N ratio,R1 for early and R2 for routine respectively,and △R as changing rate between R1 and R2.The diagnostic effectiveness of early,routine and dual-phase images was analyzed based on pathological findings.x2 test and linear correlation analysis were used for statistical analysis.Results There were 28 malignant cases (24 with HCC,2 with angiosarcoma and 2 with bile duct carcinoma)and 12 benign cases (4 with infective lesion,3 with focal nodule hyperplasia,1 with adenoma,1 with reactive hyperplasia of lymph node,1 with dysplastic nodules,1 with angioleiomyolipoma,1 with liver cirrhosis nodules).The early accumulation of 11C-AC in hepatic lesions had a positive correlation with abnormal arterial blood supply (x2 =5.62,P＜0.01).A positive correlation was also found between R1 and R2(r=0.71,P＜0.01).The AUCs of ROC curves in early,routine and dual-phase images were 0.47,0.49 and 0.68 respectively.R1,R2 and △R of HCC lesions showed negative correlation with pathological grade (r:-0.61,-0.75 and-0.67,all P＜ 0.01).Conclusions Dual-phase 11C-AC PET scan is a more effective method than routine procedure to differentiate well differentiated HCC from benign ones.11C-AC retention rate supplies useful information for final diagnosis.