葡萄膜肿瘤/诊断%正电子发射断层显像术%氟放射性同位素/诊断应用%体层摄影术,X线计算机
葡萄膜腫瘤/診斷%正電子髮射斷層顯像術%氟放射性同位素/診斷應用%體層攝影術,X線計算機
포도막종류/진단%정전자발사단층현상술%불방사성동위소/진단응용%체층섭영술,X선계산궤
Uveal neoplasms/diagnosis%Positron-emission tomography%Fluorine radioisotopes/iagnostic use%Tomography,X-ray computed
目的 初步探讨18氟-氟代脱氧葡萄糖(18F-FDG)正电子发射断层(PET)/计算机辅助断层(CT)检查在葡萄膜黑色素瘤诊断中的应用价值.方法 经眼球摘除组织病理学或影像学检查确诊为葡萄膜黑色素瘤的23例患者纳入研究.其中,男性16例,女性7例;平均年龄(49.8±12.3)岁.均为单跟,右眼11只,左眼12只.经眼球摘除病理组织证实诊断15例,经荧光素眼底血管造影、眼部B型超声及核磁共振成像等影像学诊断8例.经眼球摘除组织病理学证实诊断的15例患者中,混合细胞型7例,梭形细胞型6例,上皮细胞型2例.以混合细胞型与上皮样细胞型为影响预后因素的高危型,梭形细胞型为低危型.所有患者均行18F-FDG PET/CT检查,计算标准摄取值(SUV).以最大SUV(SU Vmax)≥2.5为恶性肿瘤的诊断标准.CT观察肿瘤形状、位置,并测量肿瘤基底最大径及隆起高度.Spearman等级相关检验分析SUVmax与肿瘤基底最大径、隆起高度的相关性.对比分析18 F-FDG PET/CT对影响预后因素的高危型和低危型患者的检出率.结果 所有患者CT像均见眼内异常高密度影.其中,半球形8例,扁平形7例,蘑菇形4例,类圆形3例,弥漫形1例.肿瘤位于后极部9例,颞侧赤道部5例,鼻侧赤道部4例,上方赤道部、颞侧睫状体、下方睫状体、颞侧虹膜、鼻侧虹膜睫状体各1例.患者SUV.x为1.1～7.8.其中,SUVmax≥2.5者9例,占39.13％;SUVmax＜2.5者14例,占60.87％.SUVmax≥2.5的9例患者,平均肿瘤基底最大径(17.53±3.48) mm,平均肿瘤隆起高度(11.37±3.85) mm.SUVmax＜2.5的14例患者,平均肿瘤基底最大径(10.66±3.25) mm,平均肿瘤隆起高度(5.33±2.23) mm.SUVmax≥2.5者平均肿瘤基底最大径及平均隆起高度均大于SUVmax＜2.5者,差异有统计学意义(t=4.815、4.786,P＜0.01).Spearman等级相关检验结果显示,SUVm.与肿瘤基底最大径、隆起高度均呈正相关(r=0.881、0.809,P＜0.01).经眼球摘除病理组织证实诊断的15例患者中,SUVmax≥2.5者8例,包括混合细胞型6例、上皮样细胞型1例、梭形细胞型1例.18F-FDGPET/CT对高危型、低危型患者的检出率分别为77.78％、16.67％.F-FDGPET/CT高危型检出率较低危型明显提高,差异有统计学意义(x2=5.402,P＜0.05).结论 18F-FDG PET-CT能显示体积较大的葡萄膜黑色素瘤,并可能协助进行手术前预后评估;但对较小病灶显示不足.不推荐其作为葡萄膜黑色素瘤的常规辅助检查.
目的 初步探討18氟-氟代脫氧葡萄糖(18F-FDG)正電子髮射斷層(PET)/計算機輔助斷層(CT)檢查在葡萄膜黑色素瘤診斷中的應用價值.方法 經眼毬摘除組織病理學或影像學檢查確診為葡萄膜黑色素瘤的23例患者納入研究.其中,男性16例,女性7例;平均年齡(49.8±12.3)歲.均為單跟,右眼11隻,左眼12隻.經眼毬摘除病理組織證實診斷15例,經熒光素眼底血管造影、眼部B型超聲及覈磁共振成像等影像學診斷8例.經眼毬摘除組織病理學證實診斷的15例患者中,混閤細胞型7例,梭形細胞型6例,上皮細胞型2例.以混閤細胞型與上皮樣細胞型為影響預後因素的高危型,梭形細胞型為低危型.所有患者均行18F-FDG PET/CT檢查,計算標準攝取值(SUV).以最大SUV(SU Vmax)≥2.5為噁性腫瘤的診斷標準.CT觀察腫瘤形狀、位置,併測量腫瘤基底最大徑及隆起高度.Spearman等級相關檢驗分析SUVmax與腫瘤基底最大徑、隆起高度的相關性.對比分析18 F-FDG PET/CT對影響預後因素的高危型和低危型患者的檢齣率.結果 所有患者CT像均見眼內異常高密度影.其中,半毬形8例,扁平形7例,蘑菇形4例,類圓形3例,瀰漫形1例.腫瘤位于後極部9例,顳側赤道部5例,鼻側赤道部4例,上方赤道部、顳側睫狀體、下方睫狀體、顳側虹膜、鼻側虹膜睫狀體各1例.患者SUV.x為1.1～7.8.其中,SUVmax≥2.5者9例,佔39.13％;SUVmax＜2.5者14例,佔60.87％.SUVmax≥2.5的9例患者,平均腫瘤基底最大徑(17.53±3.48) mm,平均腫瘤隆起高度(11.37±3.85) mm.SUVmax＜2.5的14例患者,平均腫瘤基底最大徑(10.66±3.25) mm,平均腫瘤隆起高度(5.33±2.23) mm.SUVmax≥2.5者平均腫瘤基底最大徑及平均隆起高度均大于SUVmax＜2.5者,差異有統計學意義(t=4.815、4.786,P＜0.01).Spearman等級相關檢驗結果顯示,SUVm.與腫瘤基底最大徑、隆起高度均呈正相關(r=0.881、0.809,P＜0.01).經眼毬摘除病理組織證實診斷的15例患者中,SUVmax≥2.5者8例,包括混閤細胞型6例、上皮樣細胞型1例、梭形細胞型1例.18F-FDGPET/CT對高危型、低危型患者的檢齣率分彆為77.78％、16.67％.F-FDGPET/CT高危型檢齣率較低危型明顯提高,差異有統計學意義(x2=5.402,P＜0.05).結論 18F-FDG PET-CT能顯示體積較大的葡萄膜黑色素瘤,併可能協助進行手術前預後評估;但對較小病竈顯示不足.不推薦其作為葡萄膜黑色素瘤的常規輔助檢查.
목적 초보탐토18불-불대탈양포도당(18F-FDG)정전자발사단층(PET)/계산궤보조단층(CT)검사재포도막흑색소류진단중적응용개치.방법 경안구적제조직병이학혹영상학검사학진위포도막흑색소류적23례환자납입연구.기중,남성16례,녀성7례;평균년령(49.8±12.3)세.균위단근,우안11지,좌안12지.경안구적제병리조직증실진단15례,경형광소안저혈관조영、안부B형초성급핵자공진성상등영상학진단8례.경안구적제조직병이학증실진단적15례환자중,혼합세포형7례,사형세포형6례,상피세포형2례.이혼합세포형여상피양세포형위영향예후인소적고위형,사형세포형위저위형.소유환자균행18F-FDG PET/CT검사,계산표준섭취치(SUV).이최대SUV(SU Vmax)≥2.5위악성종류적진단표준.CT관찰종류형상、위치,병측량종류기저최대경급륭기고도.Spearman등급상관검험분석SUVmax여종류기저최대경、륭기고도적상관성.대비분석18 F-FDG PET/CT대영향예후인소적고위형화저위형환자적검출솔.결과 소유환자CT상균견안내이상고밀도영.기중,반구형8례,편평형7례,마고형4례,류원형3례,미만형1례.종류위우후겁부9례,섭측적도부5례,비측적도부4례,상방적도부、섭측첩상체、하방첩상체、섭측홍막、비측홍막첩상체각1례.환자SUV.x위1.1～7.8.기중,SUVmax≥2.5자9례,점39.13％;SUVmax＜2.5자14례,점60.87％.SUVmax≥2.5적9례환자,평균종류기저최대경(17.53±3.48) mm,평균종류륭기고도(11.37±3.85) mm.SUVmax＜2.5적14례환자,평균종류기저최대경(10.66±3.25) mm,평균종류륭기고도(5.33±2.23) mm.SUVmax≥2.5자평균종류기저최대경급평균륭기고도균대우SUVmax＜2.5자,차이유통계학의의(t=4.815、4.786,P＜0.01).Spearman등급상관검험결과현시,SUVm.여종류기저최대경、륭기고도균정정상관(r=0.881、0.809,P＜0.01).경안구적제병리조직증실진단적15례환자중,SUVmax≥2.5자8례,포괄혼합세포형6례、상피양세포형1례、사형세포형1례.18F-FDGPET/CT대고위형、저위형환자적검출솔분별위77.78％、16.67％.F-FDGPET/CT고위형검출솔교저위형명현제고,차이유통계학의의(x2=5.402,P＜0.05).결론 18F-FDG PET-CT능현시체적교대적포도막흑색소류,병가능협조진행수술전예후평고;단대교소병조현시불족.불추천기작위포도막흑색소류적상규보조검사.
Objective To assess the use of 18-Fluorine-labelled 2-deoxy-2-fluoro-D-glucose positron emission tomography/computed tomography (18 F-FDG PET/CT) in the diagnosis of uveal melanoma.Methods Twenty-three patients with uveal melanoma confirmed by histopathologic examination or imaging examination were enrolled.There were 16 male,7 female,and the mean age was (49.8±12.3) years.All the lesions were unilateral,with 11 cases in OD,12 cases in OS.Diagnosis was confirmed by histopathological examination of enucleated eyeballs in 15 cases,by ophthalmoscope,fundus fluorescein angiography,ocular B-mode ultrasound and magnetic resonance imaging and other imaging technology in 8 cases.15 patients diagnosed by histopathologic examination of enucleated eyeballs were divided into three types including mixed (7 patients),spindle cell (6 patients) and epithelioid cell (2 patients) types.The mixed cell type and epithelioid cell type are considered as high-risk;spindle cell type is low-risk.All the patients were evaluated by whole body PET/CT.The location,size,shape,boundary of the lesions,and the relationship with adjacent structures were observed in CT images.18F-FDG uptake was quantitative expression by standardized uptake value (SUV) in PET image;positive diagnosis should be made when the maximum standardized uptake value (SUVm~) was not less than 2.5.The correlation between SUVmax and maximum diameter of tumor base,tumor height was analyzed by Spearman rank correlation test.The detection rate of high-risk and low-risk patients between 18 F-FDG PET and CT methods was comparative analyzed.Results All the CT images showed abnormal high density ocular lesions.The shape of the lesions included 8 patients of semi sphere-like,7 patients of flat-like,4 patients of mushroom-like,3 patients of round-like and 1 patient of diffuse lesions.The tumors were located in the posterior pole (9 patients),temporal equator (5 patients),nasal equator (4 patients),superior equator (1 patient),temporal ciliary body (1 patient),inferior ciliary body (1 patient),temporal iris (1 patient),and nasal iris and ciliary body (1 patient).SUVmax≥2.5 were found in 9 patients (39.13％),the largest basal diameter and height were (17.53±3.48),(11.37±3.85) mm respectively.SUVmax＜2.5 were found in 14 patients (60.87％),the largest basal diameter and height were (10.66 ± 3.25),(5.33 ± 2.23) mm respectively.The former' s largest basal diameter and height were greater than the latter 's and the difference was statistically significant (t=4.815,4.786;P＜0.01).SUVmax was positively correlated with the largest basal diameter and height respectively (r =0.881,0.809;P＜0.01).15 patients (39.13％) were diagnosed by histopathological diagnosis after enucleation,of which SUVna~2.5 were found in 8 patients which included 6 patients of mixed type,1 patient of epithelioid cell type,and 1 patient of spindle cell type.The detection rate of high-risk type (77.78％,7/9) was higher than that of low-risk type (16.67％,1/6),the difference was statistically significant (x2 =5.402,P＜0.05).Conclusions 18 F-FDG PET-CT examination can show large uveal melanoma tumor from cell metabolism,and may help to evaluate the prognosis of the preoperative patients.But,for small tumor,it has little value.We don't recommend 18F-FDG PET-CT is used as a routine examination for uveal melanoma.
