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目的:探讨18F-FDG PET/CT在颈部淋巴结转移癌的原发灶探寻中的价值。方法:收集颈部淋巴结转移癌患者39例,回顾18F-FDG PET/CT和常规影像学检查结果,并与组织病理学诊断和(或)长期临床随访资料进行比较,计算18F-FDG PET/CT与常规影像学在颈部淋巴结转移癌原发灶探寻中的灵敏度、特异度、阳性预测值(PPV)与阴性预测值(NPV)。测量最大标准化摄取值(SUVmax),结合18F-FDG PET/CT图像及临床表现做定性诊断。结果:39例患者18F-FDG PET/CT诊断灵敏度、特异度、PPV及NPV分别为82.1%、81.8%、92.0%及64.3%,常规影像学分别为57.1%、45.4%、72.7%及29.4%。18F-FDG PET/CT灵敏度、特异度均高于常规影像学。18F-FDG PET/CT比常规影像学发现了更多的转移淋巴结和其他组织转移灶。结论:18F-FDG PET/CT在探寻颈部淋巴结转移癌原发灶中比常规影像学具有较高的敏感性、特异性,而常规影像学如胃镜等可以更好地显示空腔器官,对消化、泌尿等系统肿瘤有更好的检出率。两者各有优势,不能相互取代,临床工作中需根据患者的实际情况合理选择,必要时联合应用,更好地发挥其优势。
Objective: To investigate the value of 18F-FDG PET / CT in the primary tumor exploration of cervical lymph node metastasis. Methods: Thirty-nine patients with cervical lymph node metastasis were collected. The 18F-FDG PET / CT and routine imaging findings were reviewed and compared with histopathological diagnosis and / or long-term clinical follow-up data. And sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of routine imaging in primary cervical lymph node metastasis. Measure the maximum normalized uptake value (SUVmax), combined with 18F-FDG PET / CT images and clinical manifestations do qualitative diagnosis. Results: The sensitivity, specificity, PPV and NPV of the 18F-FDG PET / CT in 39 patients were 82.1%, 81.8%, 92.0% and 64.3% respectively, and the conventional imaging was 57.1%, 45.4%, 72.7% and 29.4% . 18F-FDG PET / CT sensitivity, specificity were higher than conventional imaging. 18F-FDG PET / CT found more metastatic lymph nodes and other tissue metastases than conventional imaging. Conclusion: 18F-FDG PET / CT is more sensitive and specific than conventional imaging in detecting primary lymph node metastasis of cervical lymph nodes. Conventional imaging, such as endoscopy, can better reveal the cavity organs. Digestive, urinary system tumors have a better detection rate. Both have their own advantages, can not replace each other, clinical work needs to be based on the actual situation of patients a reasonable choice, if necessary, jointly applied to better play its advantages.