18F－FDGPET／CT对不明原因腹腔积液的临床应用价值

摘要

目的：探讨18 F－FDG PET／CT对不明原因腹腔积液的临床应用价值。方法分析106例以腹腔积液为首发症状、并行18 F－FDG PET／CT以明确积液良恶性的资料，18 F－FDG PET／CT判定结果采用两种方法：（1）PET／CT（定位）法：PET／CT诊断结果完全取决于腹膜上18F－FDG摄取情况，若是摄取增高则为恶性，同机CT只作为解剖定位；（2） PET／CT（形态）法： PET／CT结果需结合腹膜的CT形态学改变和PET上18 F－FDG摄取情况进行综合分析。结果 PET／CT（定位）鉴别腹腔积液良恶性的敏感性、特异性、准确性分别为90．2％、71．1％、82．1％，而PET／CT（形态）的敏感性、特异性、准确性分别为95．1％、93．3％、94．3％，原发灶检出率为85．2％。 PET／CT（形态）的特异性和准确性高于PET／CT（定位）（P＝0．002、P＜0．001），两者之间敏感性无统计学差别（P＝0．250）。结论在腹腔积液良恶性鉴别方面， PET／CT（形态）比PET／CT（定位）更具有临床应用价值，18 F－FDG PET／CT（形态）对恶性腹腔积液原发灶检出具有重要意义。%Objective To assess the clinical value of 18 F-FDG PET/CT for the patients with ascites of unknown causes.Methods A total of 106 patients with ascites undergoing 18 F-FDG PET/CT examination was retrospectively studied and 18F-FDG PET/CT imaging was interpreted by two ways.(1)PET/CT(localization):Diagnostic results of PET/CT depended on the degree of 18 F-FDG uptake in peritoneum with CT was trecoted as anatomical localization,and high 18F-FDG uptake in peritoneum was regarded as malignancy.(2)PET/CT(mor-phology):Morphological changes of peritoneum on CT imaging and the degree of 18 F-FDG uptake on PET ima-ging were simultaneously considered when interpreting the diagnostic results of PET/CT.Results In the differen-tial diagnosis of ascites of unknown cause,the sensitivity,specificity and accuracy of PET/CT( localization) were 90.2%,71.1%and 82.1%,respectively.These values of PET/CT(morphology)were 95.1%,93.3% and 94. 3%,and 85.2%of malignant ascites were found primary lesion.The specificity and accuracy of PET/CT( mor-phology)were higher than those of PET/CT(localization)(P=0.002,P<0.001).Statistical difference was not found in both sensitivities.Conclusion PET/CT( morphology) had higher clinical value than PET/CT( localiza-tion) in the differential diagnosis of ascites with unknown cause,and had important significance in detecting pri-mary cause of malignant ascites.