^18F-FDGPET／CT与超声造影在肝细胞癌复发判断中的对比研究

目的比较18F—FDGPET／CT与超声造影（CEUS）在HCC治疗后复发监测中的效能。方法回顾性分析27例HCC治疗后（15例部分切除术、12例射频消融）患者资料（男22例，女5例；平均年龄47岁），患者治疗后均行18F．FDGPET／CT及CEUS监测肿瘤复发，2种检查间隔时间在2周内，间隔期间未接受任何治疗。依据病理或随访（〉6个月）结果，计算PET／CT与CEUS诊断HCC复发的灵敏度、特异性及准确性。比较CEUS与PET／CT对CEUS阳性患者和CEUS阴性患者的诊断效能。采用McNemar检验分析数据。结果27例治疗后HCC患者中，25例存在肝内复发，其中11例合并肝外转移；2例肝内未见复发，但有肝外转移。18F-FDGPET／CT及CEUS对肝内病灶检出的灵敏度分别为92．0％（23／25）和60．0％（15／25），特异性均为2／2，准确性分别为92．6％（25／27）和63．0％（17／27）。15例CEUS阳性患者中，18F．FDGPET／CT及CEUS对肝内病灶检出的灵敏度及准确性均为100％（15／15）；12例CEUS阴性患者中，18F—FDGPET／CT及CEUS对肝内病灶检出的灵敏度分别为8／10和0，特异性均为2／2，准确性分别为83．3％（10／12）和16．7％（2／12）。18F-FDGPET／CT灵敏度及准确性明显高于CEUS，尤其是CEUS阴性组（x2=5．373和5．250，均P〈O．05）。18F-FDGPET／CT对肝外转移病灶的诊断灵敏度为100％（13／13）。结论18F—FDGPET／CT在评估HCC治疗后患者肝内肿瘤复发方面的灵敏度及准确性明显优于CEUS，并能有效发现肝外转移，可作为CEUS阴性而临床高度怀疑复发和转移的HCC患者的有效补充检查手段。

Comparison of ISF-FDG PET/CT and contrast enhanced ultrasound for detection of hepatoceHularcarcinoma recurrence after therapy

Objective To compare the efficiency of tSF-FDG PET/CT and contrast enhanced uhra- sound （CEUS） in detection of HCC recurrence after surgery or radiofrequency ablation （RFA）. Methods Twenty-seven HCC patients （22 males, 5 females; average age： 47 years） were included in this study, of which 15 patients underwent surgery and 12 patients underwent RFA therapy. ISF-FDG PET/CT and CEUS were performed within 2 weeks in all patients to detect recurrence. Final diagnosis was made by pathology or clinical follow-up （〉6 months）, and the sensitivity, specificity and accuracy of 1SF-FDG PET/CT and CEUS were calculated and compared. McNemar test was used for data analysis. Results Twenty-five pa- tients were diagnosed with HCC recurrence, including 11 cases with extrahepatic metastases. Another 2 pa tients had extrahepatic metastases without HCC recurrences. The sensitivity, specificity and accuracy in de tection of liver lesion with lS F-FDG PET/CT were 92.0% （23/25）, 2/2 and 92.6% （25/27）, respectively. While with CEUS, the corresponding values were 60.0% （15/25）, 2/2 and 63.0% （ 17/27）, respectively. In CEUS positive group, the sensitivity and accuracy were 100%（15/15） for both methods. In CEUS negativegroup, the sensitivity, specificity and accuracy of 18 F-FDG PET/CT in detection of liver lesion were 8/10, 2/2 and 83.3%（ 10/12）, respectively. The sensitivity and accuracy of lSF-FDG PET/CT were significantly higher than those of CEUS （0, 16.7% （2/12） ;X2 = 5.373, 5.250, both P〈0.05）. Moreover, the sensitivity of ISF-FDG PET/CT in detecting extrahepatic metastasis was 100%（13/13）. Conclusions 18F-FDG PET/CT is more sensitive and accurate than CEUS （especially in CEUS negative cases） in detecting recurrence of HCC after surt, erv nr RFA lSF-FDG PET/CT alsn could he useful for detection nf extrahenatie metastasis.