CAJ | 학술논문

目的：探讨18F-FDG PET/CT在颈部淋巴结转移癌的原发灶探寻中的价值。方法：收集颈部淋巴结转移癌患者39例，回顾18F-FDG PET/CT和常规影像学检查结果，并与组织病理学诊断和(或)长期临床随访资料进行比较，计算18F-FDG PET/CT与常规影像学在颈部淋巴结转移癌原发灶探寻中的灵敏度、特异度、阳性预测值(PPV)与阴性预测值(NPV)。测量最大标准化摄取值(SUVmax)，结合18F-FDG PET/CT图像及临床表现做定性诊断。结果：39例患者18F-FDG PET/CT诊断灵敏度、特异度、PPV及NPV分别为82.1%、81.8%、92.0%及64.3%，常规影像学分别为57.1%、45.4%、72.7%及29.4%。18F-FDG PET/CT灵敏度、特异度均高于常规影像学。18F-FDG PET/CT比常规影像学发现了更多的转移淋巴结和其他组织转移灶。结论：18F-FDG PET/CT在探寻颈部淋巴结转移癌原发灶中比常规影像学具有较高的敏感性、特异性，而常规影像学如胃镜等可以更好地显示空腔器官，对消化、泌尿等系统肿瘤有更好的检出率。两者各有优势，不能相互取代，临床工作中需根据患者的实际情况合理选择，必要时联合应用，更好地发挥其优势。
목적：탐토18F-FDG PET/CT재경부림파결전이암적원발조탐심중적개치。방법：수집경부림파결전이암환자39례，회고18F-FDG PET/CT화상규영상학검사결과，병여조직병이학진단화(혹)장기림상수방자료진행비교，계산18F-FDG PET/CT여상규영상학재경부림파결전이암원발조탐심중적령민도、특이도、양성예측치(PPV)여음성예측치(NPV)。측량최대표준화섭취치(SUVmax)，결합18F-FDG PET/CT도상급림상표현주정성진단。결과：39례환자18F-FDG PET/CT진단령민도、특이도、PPV급NPV분별위82.1%、81.8%、92.0%급64.3%，상규영상학분별위57.1%、45.4%、72.7%급29.4%。18F-FDG PET/CT령민도、특이도균고우상규영상학。18F-FDG PET/CT비상규영상학발현료경다적전이림파결화기타조직전이조。결론：18F-FDG PET/CT재탐심경부림파결전이암원발조중비상규영상학구유교고적민감성、특이성，이상규영상학여위경등가이경호지현시공강기관，대소화、비뇨등계통종류유경호적검출솔。량자각유우세，불능상호취대，림상공작중수근거환자적실제정황합리선택，필요시연합응용，경호지발휘기우세。
Objective:To retrospectively the evaluate whole body PET/CT in detecting the primary tumors in cervical lymph node metastatic carcinoma. Methods: A total of 39 cervical lymph node metastatic carcinoma patients were included, and the diagnostic results of 18F-FDG PET/CT and traditional imaging were analyzed and compared with histopathological diagnosis or clinical follow-up data retrospectively. The diagnostic sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated, respectively. The qualitative diagnosis using the maximal standard uptake value (SUVmax) was determined. Results: In all 39 patients, the sensitivity, specificity ,PPV and NPV of 18F-FDG PET/CT and traditional imaging was 82.1%, 81.8%, 92.0%, 64.3%and 57.1%, 45.4%, 72.7%, 29.4%.The sensitivity, specificity and accuracy of PET/CT were high than those of traditional imaging. 18F-FDG PET/CT detected more lymph node metastatic carcinoma and other organization metastatic carcinoma. Conclusion: PET/CT may be of relatively higher sensitivity, specificity, accuracy rate, PPV and NPV in identifying the primary tumor of cervical lymph node metastatic carcinoma. Traditional imaging detected better hollow organs than PET/CT, such as metastatic carcinoma of digestive system and urinary system. The two methods both have their advantages, and can’t replace each other. In clinical work, we should choose or combine them according to the patient’s specific circumstances, in order to better play to their advantage.