目的：探讨18 F-脱氧葡萄糖（FDG）SPECT／CT显像（18 F-FDG显像）在食管癌术前分期中的价值。方法对38例诊断明确，完善相关检查后拟行食管癌切除术的初诊食管癌患者行18 F-FDG显像。其中18例手术治疗患者原发灶及区域淋巴结转移的18 F-FDG显像结果与病理学检查相比较；所有患者的远处转移灶及20例非手术治疗患者的区域淋巴结转移根据组织病理学活检、多种影像学检查临床随访而定，随访时间均大于6个月。结果在38例患者中，18 F-FDG显像检出了全部的原发灶，检出淋巴结转移24例，真阳性22例，真阴性10例，假阳性2例，假阴性4例，敏感度、特异度和准确度分别为84．6％（22／26）、83．3％（10／12）和84．2％（32／38），检出肝转移1例，肺转移1例。结论18 F-FDG显像能够提高食管癌患者分期的准确度，具有较好的临床应用价值。%Objective To investigate the diagnostic accuracy of single photon emission computed tomography /computed tomography (SPECT/CT)for the staging of esophageal carcinoma. Methods SPECT/CT scan was performed for 38 esophageal carcinoma patients new-ly diagnosed within the week before operation and radio- and/or chemo-therapy. The diagnosis of esophageal carcinoma was established ac-cording to the histopathology examination. In 18 patients with operation,the findings of SPECT/CT of regional lymph node metastasis were compared with the histopathology examination. The distant metastasis of all patients and the regional lymph node metastasis of 20 patients without operation were diagnosed by the pathological examination,other imaging findings or/and clinical follow up for over 6 months. Results All primary lesions were detected by 18 F-FDG imaging. 18 F-FDG imaging results in 24 of 38 patients showed lymph node metastasis,and marked abnormally increasing uptake of FDG. Of the 24 cases,22 cases were true positive,10 cases true negative,2 cases false positive, and 4 cases false negative. The sensitivity,specificity and accuracy was 84. 6%(22/26),83. 3%(10/12)and 84. 2%(32/38),respective-ly. 18 F-FDG imaging showed hepatic metastasis in 1 case and solitary lung metastasis in 1 case. Conclusion Molecular coincidence detec-tion with 18 F-FDG SPECT/CT scan shows a high sensitivity,specificity and accuracy in detecting primary esophageal cancer and metastases, and it is recommended in staging and treatment options of esophageal carcinoma.
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