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目的探讨18F-FDG PET/CT在上尿路尿路上皮癌诊断中的应用价值。方法回顾性分析我中心自2000年4月至2010年12月间29例可疑上尿路尿路上皮癌患者的资料,29例患者在介入、手术及其他治疗前均行静脉尿路造影(IVU)、螺旋CT及18F-FDG PET/CT检查。分析3种影像学检查方法的诊断准确性。结果 29例中,18F-FDG PET/CT检查诊断上尿路尿路上皮癌26例(89.7%),26例均经手术病理证实为上尿路尿路上皮癌。对照手术病理结果,IVU的敏感性和特异性分别为64.0%和75.0%;螺旋CT的敏感性和特异性分别为75.0%和80.0%;而18F-FDGPET/CT的敏感性和特异性分别为92.9%和100%。18F-FDG PET/CT的敏感性高于IVU和螺旋CT(P=0.041vsCT,P=0.036vs IVU),同时特异性也高于IVU和螺旋CT(P=0.041vs CT,P=0.036vs IVU)。结论 18F-FDG PET/CT在上尿路尿路上皮癌的诊断中其敏感性和特异性均高于IVU和螺旋CT,为一种有用的临床诊断方法。上尿路尿路上皮癌的最后诊断需经手术病理证实。
Objective To investigate the value of 18F-FDG PET / CT in the diagnosis of upper urinary tract urothelial carcinoma. Methods The data of 29 patients with suspected upper urinary tract urothelial carcinoma from April 2000 to December 2010 in our center were analyzed retrospectively. 29 patients underwent intravenous urography (IVU) before intervention, surgery and other treatments ), Spiral CT and 18F-FDG PET / CT. The diagnostic accuracy of the three imaging methods was analyzed. Results Of the 29 cases, 18 cases (89.7%) of the upper urinary tract urothelial carcinomas were diagnosed by 18F-FDG PET / CT, and 26 cases were diagnosed as upper urinary tract urothelial carcinoma by surgery and pathology. The sensitivity and specificity of IVU were 64.0% and 75.0%, respectively. The sensitivity and specificity of spiral CT were 75.0% and 80.0% respectively. The sensitivity and specificity of 18F-FDG PET / CT were 92.9% and 100%. The sensitivity of 18F-FDG PET / CT was higher than that of IVU and spiral CT (P = 0.041 vs CT, P = 0.036 vs IVU) and higher specificity than IVU and spiral CT (P = 0.041 vs CT, P = 0.036 vs IVU ). Conclusion The sensitivity and specificity of 18F-FDG PET / CT in the diagnosis of upper urinary tract urothelial carcinoma are higher than those of IVU and spiral CT, which is a useful clinical diagnostic method. Upper urinary tract urothelial carcinoma need final diagnosis by pathology.