国际放射医学核医学杂志
國際放射醫學覈醫學雜誌
국제방사의학핵의학잡지
INTERNATIONAL JOURNAL OF RADIATION MEDICINE AND NUCLEAR MEDICINE
2014年
6期
398-402
,共5页
陆东燕%侯莎莎%丁恩慈%赵炎%沈婕
陸東燕%侯莎莎%丁恩慈%趙炎%瀋婕
륙동연%후사사%정은자%조염%침첩
腹膜%肿瘤%结核%正电子发射断层显像术%体层摄影术,X线计算机%脱氧葡萄糖F18
腹膜%腫瘤%結覈%正電子髮射斷層顯像術%體層攝影術,X線計算機%脫氧葡萄糖F18
복막%종류%결핵%정전자발사단층현상술%체층섭영술,X선계산궤%탈양포도당F18
Peritoneum%Neoplasms%Tuberculosis%Positron-emission tomography%Tomography,X-ray computed%Fluorodeoxyglucose F18
目的 分析结核性与恶性腹膜弥漫性病变的18F-FDG PET/CT表现,探讨PET/CT的诊断及鉴别诊断价值.方法 回顾性对比分析经病理和(或)临床证实的10例结核性腹膜炎、29例恶性腹膜病变(包括13例原发性腹膜浆液性乳头状腺癌、16例腹膜转移癌)的18F-FDG PET/CT表现.观察和记录指标:(1)壁腹膜、大网膜、肠系膜的受累情况;(2)腹腔积液情况;(3)淋巴结改变;(4)其他脏器伴随征象.对结核组与恶性组的受累腹膜18F-FDG代谢程度、腹腔积液密度及18F-FDG浓聚程度差异行两样本t检验.结果 结核性腹膜炎多为壁腹膜弥漫均匀增厚伴大网膜及肠系膜“污迹样”改变,18F-FDG分布较均匀;恶性腹膜病变多为壁腹膜、大网膜及肠系膜明显不规则增厚,呈多发结节状及饼状改变,18F-FDG分布不均匀.两组受累腹膜18F-FDG代谢均增高,结核性腹膜炎SUVmax为12.74±9.75,恶性腹膜病变SUVmax为12.45±7.40,两者之间的差异无统计学意义(t=0.099,P＞0.05).恶性腹膜病变患者腹腔积液密度低于结核性腹膜炎患者,恶性腹膜病变患者的CT值为(11.34±3.55)HU、结核性腹膜炎患者的CT值为(14.4±2.37)HU,两者之间的差异有统计学意义(t=2.53,P＜0.05);腹腔积液18F-FDG浓聚程度高于结核性腹膜炎患者,恶性腹膜病变患者SUVmax为2.10±0.65、结核性腹膜炎患者SUVmax为1.61±0.35,两者之间的差异有统计学意义(t=-2.278,P＜0.05);恶性腹膜病变患者T/NT为0.77±0.18、结核性腹膜炎患者T/NT为0.58±0.12,两者之间的差异有统计学意义(t=-3.084,P＜0.05).结论 18F-FDG PET/CT显像可同时显示腹膜病变的形态学和功能代谢改变,并全面显示其他脏器的伴随征象,综合分析其特征,有助于提高病变的诊断准确率.
目的 分析結覈性與噁性腹膜瀰漫性病變的18F-FDG PET/CT錶現,探討PET/CT的診斷及鑒彆診斷價值.方法 迴顧性對比分析經病理和(或)臨床證實的10例結覈性腹膜炎、29例噁性腹膜病變(包括13例原髮性腹膜漿液性乳頭狀腺癌、16例腹膜轉移癌)的18F-FDG PET/CT錶現.觀察和記錄指標:(1)壁腹膜、大網膜、腸繫膜的受纍情況;(2)腹腔積液情況;(3)淋巴結改變;(4)其他髒器伴隨徵象.對結覈組與噁性組的受纍腹膜18F-FDG代謝程度、腹腔積液密度及18F-FDG濃聚程度差異行兩樣本t檢驗.結果 結覈性腹膜炎多為壁腹膜瀰漫均勻增厚伴大網膜及腸繫膜“汙跡樣”改變,18F-FDG分佈較均勻;噁性腹膜病變多為壁腹膜、大網膜及腸繫膜明顯不規則增厚,呈多髮結節狀及餅狀改變,18F-FDG分佈不均勻.兩組受纍腹膜18F-FDG代謝均增高,結覈性腹膜炎SUVmax為12.74±9.75,噁性腹膜病變SUVmax為12.45±7.40,兩者之間的差異無統計學意義(t=0.099,P＞0.05).噁性腹膜病變患者腹腔積液密度低于結覈性腹膜炎患者,噁性腹膜病變患者的CT值為(11.34±3.55)HU、結覈性腹膜炎患者的CT值為(14.4±2.37)HU,兩者之間的差異有統計學意義(t=2.53,P＜0.05);腹腔積液18F-FDG濃聚程度高于結覈性腹膜炎患者,噁性腹膜病變患者SUVmax為2.10±0.65、結覈性腹膜炎患者SUVmax為1.61±0.35,兩者之間的差異有統計學意義(t=-2.278,P＜0.05);噁性腹膜病變患者T/NT為0.77±0.18、結覈性腹膜炎患者T/NT為0.58±0.12,兩者之間的差異有統計學意義(t=-3.084,P＜0.05).結論 18F-FDG PET/CT顯像可同時顯示腹膜病變的形態學和功能代謝改變,併全麵顯示其他髒器的伴隨徵象,綜閤分析其特徵,有助于提高病變的診斷準確率.
목적 분석결핵성여악성복막미만성병변적18F-FDG PET/CT표현,탐토PET/CT적진단급감별진단개치.방법 회고성대비분석경병리화(혹)림상증실적10례결핵성복막염、29례악성복막병변(포괄13례원발성복막장액성유두상선암、16례복막전이암)적18F-FDG PET/CT표현.관찰화기록지표:(1)벽복막、대망막、장계막적수루정황;(2)복강적액정황;(3)림파결개변;(4)기타장기반수정상.대결핵조여악성조적수루복막18F-FDG대사정도、복강적액밀도급18F-FDG농취정도차이행량양본t검험.결과 결핵성복막염다위벽복막미만균균증후반대망막급장계막“오적양”개변,18F-FDG분포교균균;악성복막병변다위벽복막、대망막급장계막명현불규칙증후,정다발결절상급병상개변,18F-FDG분포불균균.량조수루복막18F-FDG대사균증고,결핵성복막염SUVmax위12.74±9.75,악성복막병변SUVmax위12.45±7.40,량자지간적차이무통계학의의(t=0.099,P＞0.05).악성복막병변환자복강적액밀도저우결핵성복막염환자,악성복막병변환자적CT치위(11.34±3.55)HU、결핵성복막염환자적CT치위(14.4±2.37)HU,량자지간적차이유통계학의의(t=2.53,P＜0.05);복강적액18F-FDG농취정도고우결핵성복막염환자,악성복막병변환자SUVmax위2.10±0.65、결핵성복막염환자SUVmax위1.61±0.35,량자지간적차이유통계학의의(t=-2.278,P＜0.05);악성복막병변환자T/NT위0.77±0.18、결핵성복막염환자T/NT위0.58±0.12,량자지간적차이유통계학의의(t=-3.084,P＜0.05).결론 18F-FDG PET/CT현상가동시현시복막병변적형태학화공능대사개변,병전면현시기타장기적반수정상,종합분석기특정,유조우제고병변적진단준학솔.
Objective To analysis the 18F-FDG PET/CT features of tuberculous and cancerous diffuse peritoneal lesions and evaluate the value of 18F-FDG PET/CT in diagnosing and differentiating the lesions.Methods The 18F-FDG PET/CT features of 10 tuberculous peritonitis,13 primary serous papillary carcinoma of the peritoneum and 16 peritoneal metastases were retrospectively reviewed,which had been confirmed by clinic and / or histopathology.Four indicators were observed and graded:(1) 18F-FDG PET/CT features of parietal peritoneum,greater omentum and mesentery; (2)features of ascites; (3)enlargement of lymph nodes; (4)accompanying signs of other organs.Two sample t test was used to differentiate the 18F-FDG uptake of peritoneal lesions,the density and 18F-FDG concentration of ascites between tuberculous peritonitis and cancerous peritonitis.Results The typical 18F-FDG PET/CT features of tuberculous peritonitis was uniformity thickening of parietal peritoneum,mesenteric and omental stains like change,widely and even distribution of the peritoneal 18F-FDG,while the cancerous peritonitis was obvious uneven thickening of parietal peritoneum,mesenteric and omental nodules and pie-shape changes,uneven distribution of the peritoneal 18F-FDG.The 18F-FDG uptake was increased in all peritoneal lesions,and there are no significant difference between the tuberculous group (SUVmax=12.74±9.75) and the cancerous group (SUVmax=12.45 ±7.40) (t=0.099,P＞0.05).The density of malignant ascites[CTavg=(11.34±3.55) HU] was obvious lower than tuberculous ascites[CTavg=(14.4±2.37)HU] (t=2.5,P＜0.05).The 18F-FDG concentration in malignant ascites (SUVmax =2.10 ±0.65,T/NT =0.77 ±0.18) was obvious higher than tuberculous ascites (SUVmax=1.61±0.35,T/NT=0.58±0.12) (t=-2.278,-3.084,both P＜0.05).Conclusion The 18F-FDG PET/CT imaging can show the morphology and metabolic changes of peritoneal lesions,and fully display the lesions in the whole body.It is important to analyze 18F-FDG PET/CT features of disuse peritoneal lesions in order to improve the accuracy of diagnosing the diffuse peritoneal lesions.
