18F-氟-2-脱氧葡萄糖正电子发射断层扫描/计算机体层摄影双时相显像对胰腺良恶性病变鉴别的诊断价值

摘要

Objective To investigate the diagnostic value of 18 F-FDG PET / CT dual phase ima-ging in differential diagnosis of benign and malignant pancreatic lesions. Methods A retrospective study was performed on 65 cases of patients with pancreatic lesions who underwent PET/CT examination. The fi-nal comprehensive diagnosis was obtained by clinical diagnostic pathology results and clinical long-term clinical follow-up:42 cases of pancreatic malignancy and 23 cases of the benign pancreatic lesions. Prophase scans and delayed scans were administered 50-60 minutes and 120-150 minutes after the intravenous injec-tion of 18 F-FDG,respectively. The SUVmax and RI were calculated for the two time points. The sensitivity, specificity and accuracy were compared. Results The SUVearly of malignant cases was ( 8. 18 ± 3. 52 ) , which was significantly higher than that of benign cases(4. 26 ± 3. 65)(t=7. 94,P<0. 05),the SUVdelay of malignant cases was ( 10. 34 ± 4. 46 ) , which was significantly higher than that of benign cases ( 4. 55 ± 3. 37)(t=2. 67,P<0. 05). There was no significant difference between SUVearly and SUVdelay in benign ca-ses(t=0. 78,P >0. 05),while in malignant cases,SUVdelay was significantly higher than SUVearly (t =-5. 14,P<0. 05). RI of malignant cases was(27. 76 ± 20. 65)％,which was significantly higher than that of benign cases(7. 54 ±17. 33)％(t=8. 42,P<0. 01). The sensitivity,specificity and accuracy of PET/CT in diagnosing pancreatic malignancy were 81. 6％,31. 2％,69. 2％,respectively,while those of dual phase RI were 86. 5％,61. 5％ and 81. 5％. Conclusion 18 F-FDG PET/CT dual phase imaging plays an important role in the diagnosis of benign and malignant pancreatic lesions with higher sensitivity and specificity.%目的 探讨18F-氟-2-脱氧葡萄糖(18F-FDG)正电子发射断层扫描(PET)/计算机体层摄影(CT)双时相显像对胰腺良恶性病变鉴别的诊断价值.方法 回顾性分析65例行PET/CT检查胰腺病变患者的临床资料,经手术、组织病理学检查或随访证实,恶性患者42例,良性患者23例.所有患者注射18 F-FDG后50～60 min行早期显像,注射后120～150 min行延迟显像,记录其最大标准摄取值(SUVmax)并计算滞留指数(RI).比较二者对胰腺病变良恶性鉴别的灵敏度、特异性及准确度.结果 胰腺病理结果显示恶性病变患者SUV早期(8.18±3.52)显著高于良性病变患者(4.26±3.65),差异有统计学意义(t=7.94,P<0.05),恶性病变患者SUV延迟(10.34±4.46)高于良性病变患者(4.55±3.37),差异有统计学意义(t=2.67,P<0.05).胰腺良性病变组SUV早期和SUV延迟比较,差异无统计学意义(t=0.78,P>0.05),胰腺恶性病变组SUV早期和SUV延迟比较,差异有统计学意义(t=-5.14,P<0.05).恶性病变患者RI为(27.76±20.65)％,高于良性病变患者的(7.54±17.33)％,差异有统计学意义(t=8.42,P<0.01).PET/CT诊断胰腺恶性肿瘤的灵敏度、特异性和准确度分别为81.6％、31.2％、69.2％.双时相RI诊断其灵敏度、特异性和准确度分别为86.5％、61.5％和81.5％.结论 18 F-FDG PET/CT双时相显像在鉴别胰腺良恶性病变中有更高的灵敏度和特异性,在临床上具有重要的作用.