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目的探讨MDCT增强扫描和FDG PET/CT显像联合应用评价食管癌原发肿瘤及淋巴结转移的价值。方法所有79例食管癌患者均在1周内接受FDG PET/CT检查、增强扫描MDCT检查及手术治疗,并有明确病理结果。观察食管癌原发病灶、周围组织器官有无浸润、转移淋巴结的部位及组数,MDCT图像F、DG PET/CT图像及两者联合诊断结果与病理结果对照。结果MDCT、FDG PET/CT及两者联合对病灶检出率的敏感度分别为:78.3%、96.4%与96.4%。MDCT、FDG PET/CT及两者联合诊断T4期肿瘤的敏感度分别为:70.0%、90%、90%;特异度分别为94.5%、68.5%、98.6%;准确度分别为91.6%、71.1%、97.6%;两者联合与单独FDG PET/CT的特异度(P=0.0)及准确度(P=0.0)间差异有统计学意义。增强MDCTF、DG PET/CT及两者联合诊断淋巴结转移的敏感度分别为:70.5%、86.1%、94.3%;特异度分别为:95.9%、97.1%、98.6%;准确度分别为:90.1%、94.6%、97.6%;两者联合与单独MDCT(P=0.0)或FDG PET/CT(P=0.021)的敏感度、两者联合与单独MDCT的特异度(P=0.007)、两者联合与单独MDCT(P=0.0)或FDG PET/CT(P=0.004)的准确度均有显著性差异。结论MDCT增强扫描与FDG PET/CT联合应用可克服各自缺点,提高对食管癌诊断及分期的准确性。
Objective To evaluate the value of combined MDCT and FDG PET / CT in the evaluation of primary tumor and lymph node metastasis of esophageal cancer. Methods All 79 patients with esophageal cancer underwent FDG PET / CT within 1 week, enhanced scan MDCT examination and surgical treatment, and have clear pathological results. To observe the primary lesions of esophageal cancer, the surrounding tissue and organs with or without infiltration, lymph node metastasis sites and the number of groups, MDCT images F, DG PET / CT images and the combination of both diagnosis and pathological results. Results The sensitivities of MDCT, FDG PET / CT and the combination of them were 78.3%, 96.4% and 96.4% respectively. The sensitivities of MDCT, FDG PET / CT and the combination of the two in the diagnosis of stage T4 tumors were 70.0%, 90% and 90% respectively; the specificity were 94.5%, 68.5% and 98.6% respectively; the accuracy was 91.6% and 71.1 %, 97.6%. There was significant difference between specificity and accuracy (P = 0.0) of the combined FDG PET / PET and FDG PET / CT respectively. The sensitivities of enhanced MDCTF, DG PET / CT and the combined diagnosis of lymph node metastasis were 70.5%, 86.1% and 94.3% respectively; the specificity were 95.9%, 97.1% and 98.6% respectively; the accuracy were 90.1% , 94.6% and 97.6%, respectively. The sensitivity of the two combined with single MDCT (P = 0.0) or FDG PET / CT (P = 0.021) Significantly different from the accuracy of MDCT alone (P = 0.0) or FDG PET / CT (P = 0.004). Conclusion MDCT enhanced scan combined with FDG PET / CT can overcome their respective shortcomings and improve the accuracy of diagnosis and staging of esophageal cancer.