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目的探讨~(18)F-FDG PET 在胆囊癌和胆管癌诊断、分期中的应用价值。方法回顾性分析65例胆囊及胆管病变患者~(18)F-FDG PET 或 PET/CT 显像资料。其中胆囊病变患者46例(术前7例,术后39例)、胆管病变患者19例(术前2例,术后17例)。通过目测和半定量方法(最大 SUV,SUV_(max))对图像进行分析。结果 (1)46例胆囊病变患者中,7例于术前行 PET 检查均诊断为胆囊癌,经术后病理检查证实3例为胆囊癌,2例假阳性(胆囊腺瘤、胆囊炎各1例),失访2例;其他39例为术后检查(PET 显像均为胆囊癌患者),其中21例病理检查示有残留、转移,15例阴性,失访3例,PET 诊断肿瘤残留、转移的灵敏度为91.3%,特异性为84.6%。转移灶的分布以腹腔及腹膜后淋巴结为多。(2)19例胆管癌患者,其中2例于术前行 PET 检查,1例诊断为胆管癌,另1例为阴性(后经病理检查证实为假阴性,患者为胆管腺癌);术后检查17例(PET 显像均为胆管癌患者),其中9例病理检查示有残留、转移,1例阴性,失访7例,PET 诊断肿瘤残留、转移的灵敏度为9/9,特异性为1/1。转移灶的分布以肝脏为主。结论 ~(18)F-FDG PET 显像诊断胆囊癌和胆管癌具有一定价值,但对术后再分期价值更加明显。
Objective To investigate the value of ~ (18) F-FDG PET in the diagnosis and staging of gallbladder carcinoma and cholangiocarcinoma. Methods The data of ~ (18) F-FDG PET or CT / CT in 65 patients with gallbladder and bile duct lesions were analyzed retrospectively. 46 cases of gallbladder lesions (preoperative 7 cases, 39 cases), 19 cases of bile duct lesions (preoperative 2 cases, postoperative 17 cases). Images were analyzed by visual and semi-quantitative methods (maximum SUV, SUV max). Results (1) Among the 46 cases of gallbladder lesions, 7 cases were diagnosed as gallbladder cancer by preoperative PET examination. Three cases were diagnosed as gallbladder cancer by histopathology examination and 2 cases were false positive (gallbladder adenoma and cholecystitis in 1 case ), 2 cases were lost to follow-up; the other 39 cases were postoperative examination (PET imaging were all patients with gallbladder cancer), including 21 cases of pathological examination showed residual, metastasis, 15 cases were negative, 3 cases were lost, PET diagnosis of tumor residues, The sensitivity of the transfer was 91.3% and the specificity was 84.6%. The distribution of metastases to the abdominal cavity and retroperitoneal lymph nodes as much. (2) Twenty-nine cases of cholangiocarcinoma, two of them underwent preoperative PET examination, one was diagnosed as cholangiocarcinoma and the other one was negative (after the pathological examination confirmed false negative, the patient was cholangiocarcinoma); postoperative Seven cases were examined by PET imaging. Among them, nine cases showed residual disease and metastasis, one case was negative, and seven cases were lost. PET was used to diagnose residual tumor. The sensitivity of metastasis was 9/9. The specificity was 1/1. The distribution of metastases mainly in the liver. Conclusions ~ (18) F-FDG PET imaging has some value in the diagnosis of gallbladder carcinoma and cholangiocarcinoma, but it is more significant for the postoperative staging.