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目的 探讨18F-FDG PET/CT显像在胰腺癌TNM分期中的价值以及对治疗决策影响.方法 回顾分析2014年3月-2016年5月期间武警总医院核医学科,96例确诊为胰腺癌的门诊及住院患者的18F-FDG PET/CT检查资料,并与同期的CT及MRI资料对比,了解18F-FDG PET/CT对胰腺癌的TNM分期、临床分期情况及其对治疗决策的更改情况.结果 18F-FDG PET/CT胰腺癌TNM分期与临床分期:96例胰腺癌患者中,T1-2 24例,T323例,T4 49例,N1 54例,M1 51例;早期(Ⅰ+Ⅱ)期占29.2％ (28/96);中晚期(Ⅲ+Ⅳ)期占70.8％(68/96).而同期CT及MRI检查:发现原发灶91例,其中T1-2 21例、T3 22例、T4 48例,较18F-FDG PET/CT漏诊5例;N1 47例,较18F-FDG PET/CT少发现7例;M1 40例,较18F-FDG PET/CT少发现11例;早期(Ⅰ+Ⅱ)期38例,中晚期(Ⅲ+Ⅳ)期51例.通过18F-FDG PET/CT检查,有占26.0％(25/96)的患者调整了治疗方案,5例发现为CT及MR漏诊胰腺癌原发灶;20例较CT及MRI提高了临床分期,其中5例原发灶升高至T4期、4例有手术无法清除的多发淋巴结转移、11例远处转移.结论 18F-FDG PET/CT在胰腺癌TNM分期和临床分期的价值较常规CT及MRI高,尤其对较小的原发灶、小淋巴结转移以及远处转移病灶更具优势.18F-FDG PET/CT与CT及MRI结合,能提供更准确的临床分期,为合理选择治疗方案的提供可靠的依据.“,”Objective To evaluate the value of 18F-fluorodeoxyglucose (18F-FDG) PET/CT in TNM staging and its influence on treatment decisions of pancreatic cancer.Methods A total of 96 patients who underwent 18F-FDG PET/CT examination for diagnosed pancreatic cancer during March 2014 to May 2016 were analyzed comparing with CT and MRI images of the same period retrospectively.Pathological diagnosis or regular imaging follow-up were adopted as the golden,standard.Results In 96 patients with pancreatic cancer,24 patients with T1-T2 stage,23 and 49 patients with T3 and T4 stage,54 patients in N1 stage,51 patients in M1 stage by 18F-FDG PET/CT scan.while the T staging on CT and MRI examination,the number was 21,22 and 48 in T1-2,T3 and T4 staging corresponding,5 primary pancreatic cancer were missed,91 lesions were detected altogether.47 patients in N1 stage,with 7 cases missed,and 40 patients in M1 stage,with 11 cases missed.As for clinical staging,the early stage (Ⅰ+Ⅱ) accounted for 29.2％ (28/96),the middle and late stage (Ⅲ+Ⅳ) accounted for 70.8％ (68/96) by 18F-FDG PET/CT,while the number was 38 and 51 respectively by CT and MRI staging.The treatment plans in 25 patients (25/96,accounted for 26.0％) were changed by 18F-FDG PET/CT,5 primary cancer which neglected on CT and MRI were detected on 18F-FDG PET/ CT,clinical stage was increased in 20 patients.Conclusion 18F-FDG PET/CT is more accurate than traditional imaging modality in TNM and clinical staging of pancreatic carcinoma.Especially in small primary tumor,small lymph node metastasis and distant metastasis.18F-FDG PET/CT combined with CT and MRI examination can provide more accurate clinical stage and a reliable basis for the rational selection of treatment.