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目的探讨18F-FDGPET/CT在恶性黑色素瘤诊断及分期中的应用价值。方法回顾性分析61例恶性黑色素瘤患者18F-FDGPET/CT显像,对原发恶性黑色素瘤5例、原发灶未明的淋巴结转移性恶性黑色素瘤16例及恶性黑色素瘤原发灶(不全)切除40例,分别研究PET/CT诊断恶性黑色素瘤原发灶及转移瘤的应用价值。结果5例原发恶性黑色素瘤病灶均异常摄取FDG,SUV3.52～14.76,其中2例示区域淋巴结转移并经病理确诊。3例原发灶未明的淋巴结转移性恶性黑色素瘤经18F-FDGPET/CT检出原发灶,原发灶检出率18.75%,其中2例示远处多发转移;另2例患者临床体检发现原发灶,18F-FDGPET/CT未见原发征象。40例恶性黑色素瘤原发灶(不全)切除患者中,18F-FDGPET/CT诊断原发灶残留8例,经病理确诊5例,准确率62.50%;18F-FDGPET/CT示区域淋巴结转移7例,病理确诊5例,阳性预测价值71.43%;18F-FDGPET/CT示远处多发转移14例,远处转移率35.00%(14/40);40例患者中,2例因PET/CT显像降低临床分期,11例提高分期,18例患者治疗方案改变。结论18F-FDGPET/CT在恶性黑色素瘤准确分期方面有较大临床价值,但在淋巴结转移性恶性黑色素瘤寻找原发灶的价值有限。
Objective To investigate the value of 18F-FDG PET/CT in the diagnosis and staging of malignant melanoma. Methods Retrospective analysis of 18 cases of malignant melanoma with 18F-FDG PET/CT imaging, 5 cases of primary malignant melanoma, 16 cases of metastatic malignant melanoma of primary lymphoma with unknown primary tumor and primary malignant melanoma tumor (incomplete) 40 cases were resected and PET/CT was used to diagnose the primary tumor and metastasis of malignant melanoma. Results All the 5 primary malignant melanoma lesions were abnormally uptake FDG, SUV 3.52 to 14.76, of which 2 cases showed regional lymph node metastasis and were confirmed by pathology. Three primary tumors of metastatic malignant melanoma with unidentifiable primary tumor were detected by 18F-FDG PET/CT. The primary tumor detection rate was 18.75%, of which 2 cases showed multiple metastases in the distant area; the other 2 patients had clinical findings. Foci, 18F-FDG PET/CT no primary signs. In 40 patients with malignant melanoma primary resection (incomplete) resection, 8F-FDG PET/CT diagnosis of primary tumor remains in 8 cases, 5 cases were confirmed by pathology, the accuracy rate was 62.50%; 18F-FDG PET/CT showed regional lymph node metastasis in 7 cases. 5 cases were pathologically diagnosed, with a positive predictive value of 71.43%; 18F-FDG PET/CT showed multiple metastases in distant metastasis in 14 cases, and the distant metastasis rate was 35.00% (14/40); of 40 cases, 2 cases were diagnosed by PET/CT. Decreased clinical staging, 11 cases improved staging, 18 cases of patients with treatment changes. Conclusion 18F-FDG PET/CT is of great clinical value in the accurate staging of malignant melanoma, but it is of limited value in finding primary lesions in metastatic malignant melanoma of the lymph nodes.