^18F-FDG PET-CT显像及CT灌注扫描评价乳腺癌代谢和血流特点

目的评价^18F-脱氧葡萄糖（^18F-FDG）正电子发射断层扫描（PET）-CT显像及CT灌注扫描显示乳腺癌代谢、血流特点的价值。方法32例未治疗的乳腺肿块患者,分别行PET-CT检查和CT强化扫描。所有病灶在10d内经手术切除或活检行病理组织学检查。18F-FDGPET-CT显像经半量化分析,用灌注3软件包处理CT灌注扫描图像,将两种影像学检查结果与病理诊断进行比较研究。结果良性病变和乳腺癌的^18F-FDG标准摄取值（SUV）差异具有统计学意义（P〈0．05）,乳腺癌中心和周边的^18F-FDG的SUV差异也具有统计学意义（P〈0．05）;^18F-FDG的摄取与乳腺癌病理类型和分级有关。CT灌注扫描显示血流（BF）、血量（BV）和表面渗透（Ps）在乳腺癌和正常组织中差异具有统计学意义（t=8．0650,P〈0．0001;t=2．7691,P=0．0115;T^＋=253．0000,T-=0．0000,P〈0．0001）,乳腺肿瘤周边区和中心区BF、BV和PS灌注值平均差也具有统计学意义（t=8．0158,P〈0．0001;t=2．2434,P=0．0179;t=3．4857,P=0．0022）。结论^18F-FDGPET-CT显像及CT灌注扫描可以很好的显示乳腺癌的代谢和血流灌注特征,从而间接反映乳腺癌的生物学特征,对乳腺癌的诊断和预后评估具有重要的临床价值。

Value of ^18F-FDG PET-CT imaging and CT perfusion in evaluation of metabolic and blood flow characteristics of breast cancer

Objective To explore the value of 18F 2-deoxy-2-fluoro-d-glueose （ISF-FDG） positron emission tomography （PET）/ computed tomographic （CT） imaging and CT perfusion in evaluating metabolic and blood flow characteristics in breast cancer. Methods 32 women with untreated breast masses were both ex- amined with 18 F-FDG PET/CT and CT perfusion at the same day. All the lesions were confirmed histopathologically by surgery or biopsy. The PET/CT images were analyzed semi-quantitatively. CT perfusion images were analyzed using the GE perfusion 3 soft package. The findings of two modalities above were compared with patho- logical diagnosis. Results There were significant differences between standardized uptake values （SUVs） of ISF- FDG of benign tumors and breast cancer （ Wileoxon test P = 0. 000 3, T = 15. 000, u = 3. 433, C = 1 ）. Differences of SUVs between the center and periphery of breast masses were also significant. In addition, the SUVs were related to the pathological type and the grading of tumors. In the CT perfusion, the differences of perfusion including blood flow （BF）, blood volume （BV）and permeability surface area product （PS） values between tumor and normal breast tissue were statistically significant（ t =8.065, P 〈0.000 1; t =2.769 1 ,P =0.011 5; T^＋ = 253. 000 0, T - = 0. 000 0, P 〈 0. 000 1 ） respectively. The differences of BF, BV and PS values between pe- ripheral zone and central portions of tumor were also statistically significant （ t = 8. 015 8, P 〈0.000 1; t =2.243 4, P =0.017 9; t =3.485 7, P =0.002 2）, respectively. Conclusion ISF-FDG PET/CT imaging and CT perfusion reveal the metabolic and blood flow characteristics, and reflect biological behavior of breast tumor indirectly and have important value for the diagnosis and prognosis of breast cancer.