肺癌肾上腺转移的18F-FDG PET/CT的图像分析

摘要

目的 分析肺癌肾上腺转移患者的18F-脱氧葡萄糖正电子发射计算机断层显像(18-fluorodeoxyglucose positron emission tomography/computed tomography,18F- FDG PET/CT)特征,并评价其临床应用价值.资料与方法回顾性分析本院PET-CT中心检查发现并最终确诊的肺癌肾上腺转移患者31例,共35个肾上腺转移灶,分析其CT和PET图像特征,将同期转移患者原发灶和转移灶的最大SUV(SUVmax)进行相关性分析,并用t检验比较同期转移和异期转移病灶的SUVmax的差异.结果 肺癌肾上腺转移瘤在CT表现为类圆形或不规则形的结节灶,35个病灶中密度均匀者23个,不均匀者12个,直径为0.8～10cm,平均为2.56±1.68cm;PET图像上最大SUV为1.9～22.1,平均为7.02±4.28.肺癌原发灶SUVmax为2.3～18.9,平均为8.07±4.59;肾上腺转移灶的SUVmax与原发灶的SUVmax无相关性(P=0.009,P=0.972).初诊转移与随诊转移的肾上腺转移瘤的SUVmax的差异无统计学意义(t=-0.904,P=0.373).显示3例病灶肾上腺转移瘤的变化随原发灶的好转而同步改善.结论 PET/CT检查对肺癌肾上腺转移的诊断有重要价值,可作为肾上腺转移癌的检查方法.%purpcse To analyze the image features of 18F-FDG PET/CT of adrenal metastasis of lung cancer. Materials and Methods A retrospective study was done in 31 patients(35 foci)with adrenal metastasis of lung cancer. The CT and PET image features of primary and metastatic foci were analyzed. Spearman correlation analysis was performed to determine the difference of maximum standard uptake value (SUVmax) between the primary tumor and the metastatic foci. T test was used to compare the difference of SUVmax between patients with initially diagnosed adrenal metastasis and patients with metastasis after therapy. Results On CT images, the shapes of adrenal metastatic tumors from lung cancer are oval or irregular. 23 of the 35 foci were homogeneous and 12 heterogeneous. The diameters were ranged from 0.8 cm to 10 cm, and the mean value of 2.56 cm. The range of SUVmax was 1.9 to 22.1, with the mean of 7.02±4.28. The range of SUVmax of primary foci was 2.3～18.9 (mean= 8.07±4.59). There was poor correlation (P=0.009, P=0.972) of SUVmax between the adrenal metastasis and primary tumor. While there was also no significant difference in SUVmax(t= -0.904, P=0.373) between patients with initially diagnosed adrenal metastasis and patients with metastasis after treatment. The SUVmax in three cases showed simultaneous decrease in metastatic adrenal lesions as the primary tumor improved. Conclusion 18F-FDG PET/CT is important in the diagnosing adrenal metastasis of lung cancer and can be used as a useful examination method.