CAJ | 학술논문

目的：评价以18F 标记的脱氧葡萄糖（FDG）为示踪剂的正电子发射断层成像在肝门部胆管癌术前评估中的应用价值。方法回顾性分析45例肝门部胆管癌患者的18F－FDG PET／CT 术前评估资料，总结18F－FDG PET／CT在判断 Bismuth－Corlette 分型、肿瘤部位、淋巴结转移、远处转移以及可切除评价中的应用价值。结果①PET／CT 检查中共有37例患者的 Bismuth－Corlette 分型结果与手术病理结果一致，准确率为82．22％；②PET／CT 检查在诊断淋巴结转移上的敏感性、特异度以及准确度分别为77．78％、83．33％和80．00％，PET／CT 检查在诊断远处转移上的敏感性、特异度以及准确度分别为55．56％、92．59％和77．78％；③术前 PET／CT 检查评价可切除病例有34例，术中有29例评价为可切除；术前 PET／CT 检查评价不可切除病例有11例，术中有2例评价为可切除，两者相比无统计学差异（χ2＝0．50，P ＞0．05）。结论18F－FDG PET／CT 在肝门部胆管癌的术前评估中有着较高的价值，对肝门部胆管癌的淋巴结转移以及远处转移有着较高的诊断价值，同时可以作为肿瘤可切除评价中的重要手段。
목적：평개이18F 표기적탈양포도당（FDG）위시종제적정전자발사단층성상재간문부담관암술전평고중적응용개치。방법회고성분석45례간문부담관암환자적18F－FDG PET／CT 술전평고자료，총결18F－FDG PET／CT재판단 Bismuth－Corlette 분형、종류부위、림파결전이、원처전이이급가절제평개중적응용개치。결과①PET／CT 검사중공유37례환자적 Bismuth－Corlette 분형결과여수술병리결과일치，준학솔위82．22％；②PET／CT 검사재진단림파결전이상적민감성、특이도이급준학도분별위77．78％、83．33％화80．00％，PET／CT 검사재진단원처전이상적민감성、특이도이급준학도분별위55．56％、92．59％화77．78％；③술전 PET／CT 검사평개가절제병례유34례，술중유29례평개위가절제；술전 PET／CT 검사평개불가절제병례유11례，술중유2례평개위가절제，량자상비무통계학차이（χ2＝0．50，P ＞0．05）。결론18F－FDG PET／CT 재간문부담관암적술전평고중유착교고적개치，대간문부담관암적림파결전이이급원처전이유착교고적진단개치，동시가이작위종류가절제평개중적중요수단。
Objective To evaluate the application of 18F-FDG PET/CT in assessing hilary cholangiocarcinoma before the surgery.Methods Retrospective analysis of preoperative assessment information of 45 cases of hepatic bile duct carcinoma in patients with portal vein 18F-FDG PET/CT were conducted,application of 18F-FDG PET/CT in judging Bismuth-Colette type, tumor location,lymph node metastasis,distant metastasis and respectable value evaluation were summed .Results (1)PET/CT examination showed that Bismuth -Corlette classification results of 37 cases were consistent with surgical pathology results ,the ac-curacy was 82.22%;(2)PET/CT examination in the diagnosis of lymph node metastasis on the sensitivity ,accuracy,specificity were 77.78%,83.33% and 80.00%,PET/CT examination in the diagnosis of distant metastases in sensitivity ,accuracy,speci-ficity were 55.56%,92.59% and 77.78%;(3)preoperative PET /CT examination evaluation for resectable cases was 34 cases, that of intraoperative evaluation was 29 cases;PET/CT preoperative examination evaluation for unresectable cases was 11 cases, that of intraoperative evaluation was 2 cases,there had no statistical difference(chi-square =0.50,P >0.50).Conclusion 18F-FDG PET/CT has a high value in the preoperative evaluation of hilary cholangiocarcinoma ,lymph node metastasis and distant me-tastasis,it can serve as an important means of evaluation for tumor resectablity .