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探讨牛奶造影剂充盈后延迟显像在18F-FDG PET/CT诊断胃癌中的增益价值。临床疑诊胃癌或须除外胃癌患者81例,在行18F-FDG PET/CT常规全身显像后,口服纯牛奶和复方泛影葡胺混合液500-600 m L充盈胃腔,10-20 min后进行胃局部延迟显像。肉眼分析比较胃腔充盈前后的图像差别,以手术和胃镜活检病理以及临床随访为确诊依据,评估牛奶造影剂充盈胃腔方法在PET/CT诊断胃癌中的增益价值。81例患者中,经病理确诊为胃癌者51例,良性病变30例。牛奶造影剂充盈胃腔后PET诊断胃癌的灵敏度从常规显像的60.7%提高至82.3%(?2=5.829,P=0.016),特异性从46.7%提高至76.6%(?2=5.711,P=0.017)。综合分析PET和CT所见,CT弥补了6例(6/9)18F-FDG摄取不高的胃癌病灶的检出。常规显像和牛奶造影剂充盈胃腔后延迟显像PET/CT诊断胃癌的灵敏度分别88.2%、94.1%,特异性分别为83.3%、90.0%,二者的诊断效能无显著性差异(?2=0.487,P=0.484和?2=0.144,P=0.704)。牛奶造影剂充盈后延迟显像胃癌病灶及其侵犯范围的显示程度较空腹状态时更清楚(t=6.866,P=0.000),在45.0%(23/51)弥漫型胃癌或18F-FDG摄取较低患者中提示CT的影像改变更有助于准确地显示和判断肿瘤的侵犯范围。18F-FDG PET/CT对原发性胃癌具有较高的诊断价值,采用牛奶造影剂胃充盈法尽管未能显著提高其诊断效能,却能更清晰地显示胃癌病灶及其侵犯范围。
To investigate the value of delayed imaging after filling with milk contrast agent in the diagnosis of gastric cancer by 18F-FDG PET / CT. Clinical suspicion of gastric cancer or gastric cancer patients should be 81 cases, in the line of 18F-FDG PET / CT conventional whole body imaging, oral pure milk and compound diatrizoate mixture of 500-600 m L filling the gastric cavity, 10-20 min After the local delayed gastric imaging. Macroscopic analysis was performed to compare the difference of the images before and after the filling of the gastric cavity. To evaluate the value of the method of filling the gastric cavity with milk contrast agent in the diagnosis of gastric cancer by PET / CT based on the pathological and surgical follow-up of operation and endoscopy. Of the 81 patients, 51 were pathologically diagnosed as gastric cancer and 30 were benign lesions. Sensitivity of PET in the diagnosis of gastric cancer after filling the gastric cavity with milk contrast agent increased from 60.7% to 82.3% (? 2 = 5.829, P = 0.016) and specificity from 46.7% to 76.6% (? 2 = 5.711, P = 0.017). A comprehensive analysis of PET and CT findings, CT to make up for 6 cases (6/9) 18F-FDG uptake of gastric cancer detection is not high. The sensitivity and specificity of PET / CT in the diagnosis of gastric cancer by conventional imaging and milk contrast media after filling the gastric cavity were 88.2%, 94.1% and 83.3%, respectively, with no significant difference (P> 0.05) = 0.487, P = 0.484 and? 2 = 0.144, P = 0.704). Compared with the fasting state, delayed imaging imaging of delayed-imaging gastric cancer and its extent of invasion after milk contrast filling showed more clearly (t = 6.866, P = 0.000), and in 45.0% (23/51) diffuse gastric cancer or 18F-FDG uptake In patients with low prompt CT image changes help more accurately display and determine the extent of tumor violations. 18F-FDG PET / CT has a high diagnostic value for primary gastric cancer. Although the milk-filled gastric filling method failed to significantly improve its diagnostic efficacy, 18F-FDG PET / CT can clearly show the extent of gastric cancer lesions and their invasion.