18F-FDG PET/CT显像对胃肠肿瘤术后肠梗阻病因学的诊断价值

摘要

Objective To explore the significance of 18fluorodeoxyglucose positron emission tomography(18F⁃FDG PET/CT)in the etiological diag⁃nosis of postoperative intestinal obstruction in patients with gastrointestinal cancer. Methods A total of 51 patients with postoperative intestinal ob⁃struction undergone 18F⁃FDG PET/CT were enrolled for the study. The images were interpreted by visual and semi⁃quantitative analysis(maximum standard uptake value,SUVmax). All the cases were confirmed by pathology and clinical follow⁃up for more than half a year. The sensitivity,specifici⁃ty and accuracy of 18F⁃FDG PET/CT for detecting malignant intestinal obstruction were calculated. Results Of the 51 patients,35 cases were con⁃firmed for malignant intestinal obstruction,and 16 cases were caused by other benign diseases. 18F⁃FDG PET/CT imaging was positive in 36 cases, and 33 cases were diagnosed as malignant and recurrent intestinal obstruction. Three cases of PET false⁃positive were peritonitis adhesion and anasto⁃motic inflammation. Two cases of PET false negative were peritoneal micrometastasis. The SUVmax of malignant lesions was 8.86±4.82,and the SUVmax of benign lesions was 2.05±1.95. The uptake of FDG was significantly higher in malignant intestinal obstruction than in benign intestinal obstruction (t=7.15,P<0.01). The sensitivity,specificity,and accuracy of 18F⁃FDG PET/CT diagnosis of malignant lesion were 94.3%,81.3%,and 90.2%, respectively. Conclusion The uptake of 18F⁃FDG in malignant intestinal obstruction was higher than that in benign intestinal obstruction. 18F⁃FDG PET/CT have a good diagnostic value for the intestinal obstruction of postoperative gastrointestinal cancer.%目的：探讨氟－代脱氧葡萄糖正电子发射型断层显像（18F⁃FDG PET/CT）显像对胃肠肿瘤术后肠梗阻病因学的诊断价值。方法胃肠肿瘤术后不明原因肠梗阻行18F⁃FDG PET/CT显像的患者51例，图像分析采用视觉定性和通过半定量分析测量病变最大标准摄取值（SUVmax）。所有患者经手术病理学诊断或临床≥6个月以上的随访。计算18F⁃FDG PET/CT显像诊断胃肠肿瘤术后肠梗阻病因的敏感度、特异度和准确性。结果51例患者中，35例患者最终诊断为恶性肿瘤复发性肠梗阻，16例为非复发性肠梗阻。18F⁃FDG PET/CT显像阳性36例，其中33例患者最终诊断为恶性肿瘤复发性肠梗阻，3例显像假阳性为腹膜炎粘连性肠梗阻、吻合口炎症。2例18F⁃FDG PET/CT显像假阴性为腹膜微浸润。恶性肿瘤复发性肠梗阻病变的SUVmax为8.86±4.82，非复发性肠梗阻病变的SUVmax为2.05±1.95，两者差异有统计学意义（t=7.15，P<0.01）。18F⁃FDG PET显像诊断恶性肿瘤复发性肠梗阻的敏感度为94.3%，特异度为81.3%，准确性为90.2%。结论恶性肿瘤复发性肠梗阻的18F⁃FDG摄取率明显高于非复发性肠梗阻，18F⁃FDG PET/CT显像对肠梗阻病因学有很好的诊断价值。