Objective To explore the value of 18 F-FDG PET delayed imaging in differentiation of malignant from benign lesions in the pancreas. Methods Forty-two patients with clinically suspected malignant pancreatic lesions including 27 cases with pancreatic cancer and 15 cases with chronic pancreatitis. The finally definite diagnosis was obtained by pathology and imageologic or clinical follow-up. All patients underwent 18 F-FDG PET 1h early and 2h delayed imaging after intravenous injection of 252 ~356 MBq of 18 F-FDG. The standardized uptake value(SUV) was calculated for both time points, and retention index(RI) was al-so calculated. Results The SUV of pancreatic cancer in delayed imaging were significantly higher in early imaging(P < 0. 01). However,the SUV of pancreatitis in delayed imaging were significantly lower in early imaging(P < 0. 01). Take early imaging SUV > 2. 5 as standard, the sensitivity, speciality and accuracy of diagnosis was 83. 3% , 76. 2% and 81. 0% respectively. Take delayed imaging SUV > 2. 5 as standard, the sensitivity, speciality and accuracy of diagnosis was 88. 1% , 81. 0% and 85. 7% re-spectively. Take RI > 15% as standard, the sensitivity, speciality and accuracy of diagnosis was 90. 5% , 85. 7% and 88. 1% . When combining delayed imaging SUV > 2. 5 and RI > 15% as standard,the sensitivity, speciality and accuracy of diagnosis was 95. 2% , 88. 1% and 92. 9% respectively. Conclusion 18 F-FDG PET delayed imaging is a reliable imaging protocol fordifferen-tiating malignant from benign lesions in the pancreas. Combining delayed imaging SUV and RI can improve the accuracy of diagno-sis.%目的：探讨18 F-脱氧葡萄糖(FDG) PET/ CT 延迟显像对胰腺良恶性病变的鉴别诊断价值。方法42例临床疑为胰腺恶性肿瘤患者通过组织病理学、影像学和临床随访,最后证实27例为胰腺癌,15例为慢性胰腺炎。所有患者均于静脉注射18 F-FDG 40~60min 后进行 PET/ CT 早期显像和注射2h 后进行 PET/ CT 延迟显像,测定两次显像病灶的标准摄取值(SUV)和18 F-FDG 的储留指数(RI)来评估诊断价值。结果胰腺癌组延迟显像 SUV 较早期显像明显增高(P <0.01),胰腺炎组延迟显像 SUV 较早期显像明显降低(P <0.01),胰腺癌组的 RI 明显高于胰腺炎组(P <0.01)；以早期显像 SUV >2.5作为标准,诊断的灵敏度、特异性、准确性分别为83.3%、76.2%、81.0%；以延迟显像 SUV >2.5作为标准,诊断的灵敏度、特异性、准确性分别为88.1%、81.0%、85.7%；以 RI >15%作为标准,诊断的灵敏度、特异性、准确性分别为90.5%、85.7%、88.1%；结合延迟显像 SUV >2.5和 RI >15%两项标准,诊断的灵敏度、特异性、准确性分别为95.2%、88.1%和92.9%。结论18 F-FDG PET/ CT 延迟显像有助于胰腺良恶性病变的鉴别诊断,结合应用延迟显像 SUV 及RI 两项指标可提高诊断准确率。
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