PET/CT与CT增强对喉癌及喉咽癌术前分期的诊断价值

摘要

目的:分析18F脱氧葡萄糖 (18F-FDG) 正电子发射计算机断层显像 (PET/CT) 与螺旋电子计算机断层扫描 (CT) 增强扫描在喉癌及喉咽癌术前分期中的价值.方法:28例确诊为喉癌及喉咽癌的患者于术前行PET/CT显像和CT增强扫描, 观察影像学表现、并与术后病理检查结果进行对比, 比较两种检查对喉癌及喉咽癌术前分期的灵敏度、特异度和准确度.结果:28例患者中喉癌21例 (颈部淋巴结转移6例) 、喉咽癌7例 (颈部淋巴结转移5例), PET/CT显像及增强CT对喉癌、喉咽癌的术前T分期结果与术后病理T分期结果的符合率分别为73.54％和66.12％, 差异无统计学意义 (P＞0.05); PET/CT显像与CT增强对患者颈部淋巴结转移的灵敏度分别为93.21％和76.92％、差异有统计学意义 (χ2=0.26, P＜0.05), 特异度分别为60％和73.33％、准确度均为75％, 差异无统计学意义 (P＞0.05) .结论:18F-FDG PET/CT或CT增强对喉癌及喉咽癌颈部淋巴结转移均具有较好的诊断价值, 有助于指导临床进行治疗前诊断和分期.%Objective:To analyze the value of 18 F-FDG PET/CT and enhanced CT in the diagnosis of preoperative staging of laryngeal carcinoma and hypopharyngeal carcinoma.Methods:28 patients with laryngeal carcinoma and hypopharyngeal carcinoma underwent PET/CT and enhanced CT before operations.The imaging findings were observed and compared with the postoperative pathological findings.The sensitivity, specificity and accuracy of the two examinations for the preoperative staging of laryngeal carcinoma and hypopharyngeal carcinoma were compared.Results:There were 21 cases of laryngeal carcinoma (6 cases with cervical lymph node metastasis) and 7 cases of hypopharyngeal carcinoma (5 cases with cervical lymph node metastasis).The coincidence rates of preoperative T staging and postoperative pathological T staging were 73.54％ and 66.12％ respectively.There was no significant difference (P＞0.05).The sensitivity of PET/CT and enhanced CT to cervical lymph node metastasis was 93.21％ and 76.92％ respectively and the difference was statistically significant (χ2=0.26 P＜0.05).The specificity was 60％ and 73.33％ respectively and the accuracy was 75％.There was no significant difference (P＞0.05).Conclusion:Both 18 F-FDG PET/CT and enhanced CT have good diagnostic value for cervical lymph node metastasis of laryngeal carcinoma and hypopharyngeal carcinoma, which is helpful for clinical diagnosis and staging before treatment.