18F-FDG PET-CT在多浆膜腔积液探查肿瘤原发灶中的价值

摘要

Objective The present study was conducted to research on the value of 18 F-solid glucose positron emis-sion tomography (18 F-FDG PET)/CT whole body imaging for detection of original disease of polyserositis with un-known original disease.Methods In the retrospective analysis there were 84 patients with polyserositis,which from Jun.2006 to Jun.2013.And their PET-CT imaging data would be compared with pathology and clinical follow-up re-ports.Results The univariate analysis showed that in the 84 patients with polyserositis there were 42 cases with hy-drothorax and ascites,30 cases with pericardial effusion and pleural effusion,6 cases with hydroperitoneum and hydro-pericardium,and 6 cases with pericardial effusion,hydroperitoneum and pleural effusion.The first two kinds of polyser-ositis were more common in clinical.Ovarian cancer,peritoneal carcinoma and lung cancer were often seen with pleural effusion & ascites and lung cancer with pleural effusion& pericardial effusion.Pathology and clinical follow-up results confirmed 62 cases suffered with malignancy.Of these patients,primary tumors of 49 cases were confirmed by PET-CT.There were 1 9 cases with benign disease.And the other 3 cases of diagnosis were unknown.The accuracy for the diagnosis of patients with multiple effusion was higher when the SUVmax value was taken 3.6 through ROC curve. Conclusion 18 F-FDG PET-CT whole body imaging was a important tool in detection original disease of polyserositis, especially suspicious malignant tumor.In the treatment it also had a significant value.%目的：探讨18 F脱氧葡萄糖正电子发射体层摄影术（18 F-FDG PET-CT）全身显像在可疑恶性肿瘤所致多浆膜腔积液中的应用价值。方法回顾性分析2006年6月至2013年6月期间84例以多浆膜腔积液为首发症状临床可疑恶性肿瘤患者的PET-CT显像资料，并将显像结果与病理及临床随访结果进行对比分析。结果84例患者中有62例经病理及临床随访证实为恶性。84例多浆膜腔积液患者中胸水＋腹水42例，胸水＋心包积液30例，腹水＋心包积液6例，胸水＋腹水＋心包积液6例，胸水合并腹水以卵巢癌、腹膜癌及肺癌多见，胸水合并心包积液以肺癌多见。62例恶性肿瘤患者中通过 PET-CT检查明确原发灶49例，检出率为79．0％。有19例最终排除恶性肿瘤诊断，另3例未能明确诊断。以病理及临床随访诊断结果为标准，通过绘制 ROC曲线 SUVmax取3．6为截断值时 SUV-max用于诊断多浆膜腔积液患者的可疑原发灶良恶性的准确度最高，敏感性为90．3％，特异性为81．8％，阳性预测值93．1％，阴性预测值65．2％。结论18 F-FDG PET-CT全身显像在不明原因多浆膜腔积液中有重要价值，尤其是可疑恶性肿瘤者，能在定性诊断的基础上明确定位并准确分期，指导治疗。