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目的:探讨18F-脱氧葡萄糖(FDG)PET或PET/CT显像在肾上腺病变鉴别诊断中的应用价值。方法:25例肾上腺占位患者均行18FDG PET或PET/CT图像,检查后1月内19例经手术切除,6例经穿刺活检获得病理结果,25例均有同期术前CT增强扫描。按照肾上腺占位是否产生内分泌症状分为有功能病变组(组A,8例)和无功能病变组(组B,17例),对18FDG PET或PET/CT图像所示肾上腺病变行半定量分析,计算肾上腺病变SUVm ax值及肾上腺病变/肝脏SUV-m ax比值。结果:1.有功能病变组的临床多表现为库欣综合征和高血压,良性病变SUVm ax为5.04±2.07,恶性病变的SUVm ax为8.33±2.57.良性肾上腺病变/肝脏SUVm ax的比值为2.52±0.62,恶性肾上腺病变/肝脏SUVm ax的比值为2.92±1.03。良性病变的大小为3.26±1.01 cm,明显小于恶性病变(7.80±1.82 cm)。2.无功能病变组,恶性病变的SUVm ax为11.39±7.96明显高于良性病变(1.93±0.54)。恶性肾上腺病变/肝脏SUVm ax的比值为4.51±2.92,明显高于良性肾上腺病变/肝脏SUVm ax的比值(0.76±0.20)。良性病变的大小为2.25±0.69 cm,小于恶性病变(5.62±3.95 cm)。结论:对于无功能的肾上腺病变,18FDG PET和PET/CT是鉴别诊断其良恶性的一种非常好的办法。而对于有功能的肾上腺病变,在综合其临床表现和影像学特点的前提下依靠病变的大小和SUVm ax,18FDG PET和PET/CT仍然可以鉴别诊断其良恶性。
Objective: To investigate the value of 18F-FDG PET or PET / CT in the differential diagnosis of adrenal lesions. Methods: Twenty-five patients with adrenal space were examined by 18FDG PET or PET / CT. Twenty-nine patients were surgically removed within one month after the operation. Pathologic findings were obtained by biopsy in six patients. Preoperative CT scan was performed in all 25 patients. According to the adrenal gland occupancy whether there are endocrine symptoms were divided into functional lesion group (group A, 8 cases) and no functional lesion group (group B, 17 cases), 18FDG PET or PET / CT image showed semi-quantitative analysis of adrenal lesions , Calculated adrenal lesions SUVm ax value and adrenal lesions / liver SUV-m ax ratio. The clinical manifestations in patients with functional lesion were Cushing’s syndrome and hypertension, the SUVm ax was 5.04 ± 2.07 in benign lesions, and the SUVm ax in malignant lesions was 8.33 ± 2.57. The ratio of benign adrenal lesions to liver SUVm ax was 2.52 ± 0.62, and the ratio of malignant adrenal lesions to liver SUVm ax was 2.92 ± 1.03. The size of benign lesions was 3.26 ± 1.01 cm, which was significantly smaller than that of malignant lesions (7.80 ± 1.82 cm). In non-functional group, the SUVm ax of malignant lesions was significantly higher than that of benign lesions (11.39 ± 7.96, 1.93 ± 0.54). The ratio of malignant adrenal lesions to liver SUVm ax was 4.51 ± 2.92, which was significantly higher than that of benign adrenal lesions / liver SUVm ax (0.76 ± 0.20). The size of benign lesions was 2.25 ± 0.69 cm, less than the malignant lesions (5.62 ± 3.95 cm). Conclusion: 18FDG PET and PET / CT are a very good method to differentiate benign and malignant lesions in non-functioning adrenal lesions. For functional adrenal lesions, 18FDG PET and PET / CT can still differentiate their benign and malignant lesions depending on the size of the lesion and the SUVmax, based on their clinical features and imaging features.