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[目的]探讨氟-18脱氧葡萄糖(18FFDG)与碳-11乙酸盐(11CAC)PET联合显像在肝肿瘤诊断中误诊的原因。[方法]收集18例肝肿瘤患者临床资料。每例患者1周内按常规行PET联合显像,用视觉分析法评价肿瘤代谢情况,并据此确定PET诊断结果,以手术病理结果为金标准,分析联合显像误诊原因。[结果]假阳性患者12例,包括18FFDG与11CAC显像均阳性3例,分别为肝原发肝细胞癌(HCC)、反应性增生淋巴结及结核;因18FFDG阳性而误诊2例,分别为慢性炎性病变和寄生虫感染;因11CAC阳性误诊7例,分别为局灶性结节样增生(FNH)、硬化结节各2例,肝腺瘤、异型增生结节和血管平滑肌脂肪瘤各1例。假阴性患者6例,包括5例中—低分化HCC病变以及1例类癌肝转移。[结论]联合显像本身存在缺陷、11CACPET显像经验不足以及未能密切联系临床检查结果是导致18FFDG和11CAC联合显像误诊的主要原因。
[Objective] To investigate the causes of misdiagnosis in the diagnosis of hepatic tumors by combining fluorine-18 deoxyglucose (18 FFDG) and carbon-11 acetate (11CAC) PET. [Method] The clinical data of 18 patients with liver cancer were collected. Each patient within 1 week according to conventional PET combined imaging, with visual analysis of tumor metabolism, and to determine the PET diagnostic results, the surgical pathology results as the gold standard analysis of the causes of misdiagnosis. [Results] 12 cases of false-positive patients, including 18 cases of FFDG and 11CAC positive imaging were positive cases of primary hepatocellular carcinoma (HCC), reactive hyperplastic lymph nodes and tuberculosis; 2 cases were misdiagnosed as 18FFDG positive, which were chronic Inflammatory lesions and parasitic infections. Seven patients were misdiagnosed as 11CAC, which were focal nodular hyperplasia (FNH), two sclerosis nodules, two hepatic adenomas, dysplastic nodules and angiomyolipoma respectively example. 6 cases of false-negative patients, including 5 cases of moderate-poorly differentiated HCC lesions and 1 case of carcinoid liver metastases. [Conclusion] The combined imaging has its own defects. The lack of experience of 11CACPET imaging and the lack of close correlation between clinical examination results are the main reasons leading to the misdiagnosis of 18FDG and 11CAC imaging.