18F-FDG SPECT/CT符合线路显像在鼻咽癌诊断中的应用价值

目的探讨18F-FDG SPECT/CT符合线路显像在鼻咽癌诊断和分期中的价值。方法 2010年1月～2012年4月我院耳鼻喉科高度怀疑鼻咽癌患者28例,最终经喉镜活检及随访明确为鼻咽癌19例,鼻咽部炎症等良性改变9例。所有患者均行18F-FDG SPECT/CT符合线路显像,喉部增强CT及MRI检查等资料齐全。统计18F-FDG SPECT/CT符合线路显像、CT及MRI三种检查结果,计算灵敏度、特异性、准确性、阳性预测值和阴性预测值等指标,行χ2检验、Fisher’s分析。结果鼻咽癌患者18F-FDG SPECT/CT显像表现为鼻咽部不对称性增厚或患侧隐窝的缩小直至消失,原发病灶及转移性淋巴结多呈异常放射性浓集,T/NT>2.5。符合线路显像诊断鼻咽癌的灵敏度、特异性、准确性、阳性预测值、阴性预测值明显高于CT(χ2=6.26、4.00、10.22、4.24、5.49,P均<0.05),其准确性高于MRI(χ2=4.91,P<0.05)。结论18F-FDG SPECT/CT符合线路显像在诊断原发性鼻咽癌及肿瘤分期方面均具有很好的实用性。

Diagnostic value of 18F-FDG coincidence imaging in nasopharyngeal carcinoma

Objective To evaluate the value of 18F-FDG coincidence imaging in diagnosis and staging of nasopharyngeal carcinoma. Methods Twenty-eight patients with suspicious diagnosis of nasopharyngeal carcinoma were observed, which included 19 cases of nasopharyngeal carcinoma and 9 patients with benign disease such as inflammation. Image character- istics of 18F-FDG coincidence imaging were analyzed and T/NT of the tumor was calculated. Sensitivity, specificity, accu- racy, PPV and NPV in diagnosis of nasopharyngeal carcinoma were calculated and compared among 18F-FDG coincidence imaging, CT and MRI. χ2 test or Fisher＇s analysis were used for analysis. Results The characteristics of nasopharyngeal neoplasms in 18F-FDG coincidence imaging included thickening of pharynx nasalis, side cryptae diminution or abolition, o- riginal disease and metastasis lymph node with abnormal radioactivity collection, the counts of target/non-target （T/NT） larger than 2.5. The sensitivity, specificity, accuracy, PPV and NPV in 18F-FDG coincidence imaging were higher than those in CT （χ2=6.26, 4.00, 10.22, 4.24, 5.49, P 〈 0.05）. The accuracy of 18F-FDG coincidence imaging was higher than that in MRI （χ2=4.91, P 〈 0.05）. Conclusion 18F-FDG coincidence imaging is helpful in diagnosis and staging of nasopharyngeal carcinoma.