正电子发射体层摄影-CT检查对眼眶眼球恶性肿瘤的诊断价值

摘要

目的 探讨正电子发射体层摄影-X线电子计算机体层摄影(positron emission tomography-computer tomography,PET-CT)检查对眼眶及眼球恶性肿瘤的诊断价值.方法 对眼眶及眼球恶性肿瘤33例(41眼).病程1月～5年,行18氟-2-氟-2-脱氧-D-葡萄糖(18F-2-fluoro-2-deoxy-D-glucose,18F-FDG) PET-CT肿瘤代谢全身体层融合显像.结果 术后病理学证实眼眶眼球恶性肿瘤33例,其中淋巴瘤16例,脉络膜黑色素瘤7例,视网膜母细胞瘤4例,眼眶转移瘤6例.17例在眼眶或眼球局部或在其外的皮肤、淋巴结、骨骼、内脏等组织器官有18F-FDG高代谢灶,明确提示为眼眶或眼球恶性肿瘤或转移瘤,3例未能给予明确提示,结合临床进一步检查确诊.13例提示术后或化疗后改变,其中4例可见18F-FDG放射性浓集灶,提示恶性肿瘤术后残留、复发或转移,9例未见18F-FDG浓聚,提示治疗效果良好.结论 PET-CT肿瘤全身断层融合显像通过人体组织的分子功能及CT复合影像,对眼眶及眼球肿瘤的良恶性质鉴别有重要参考价值;对肿瘤术后有无残留、复发和疗效监测有重要临床意义.%Objective To investigate the value of PET-CT in the diagnosis of patient with malignant tumor of the orbit and eyeball.Methods 18 F-FDG PET-CT examination was excuted in 33 patients with orbital or eyeball malignant tumor with the course from 1 month to 5 years.Results All the 33 cases with orbital and eyeball malignant tumor were confirmed by pathologic examination,including lymphoma (16 cases),choroidal melanoma (7 cases),retinoblastoma (4 cases),metastatic tumors to the orbit (6 cases).17 cases showed high FDG uptake at PET-CT in the orbit or the local eye,or in the skin,lymphnode,bone and internal organs,which clearly suggested that the lesions were orbital or eye malignant tumors and metastatic tumors.3 cases need diagnosis with further clinical examinations.13 cases indicated changes due to surgeryand chemotherapy,including 4 cases showed radioactivityconcentrated lesions suggesting residual,recurrent or metastatic malignant lesions.9 cases showed no 18F-FDG uptake,suggesting good therapeutic effect.Conclusion PET-CT fusion imaging combined molecular functional imaging with CT imaging.PET-CT has important value to identify benign and malignant lesions in orbital and ocular tumors,and it also has important clinical value in detecting residual and recurrent lesions and evaluating the therapeutic effect.