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18F-FDG PET/CT诊断原发性肝癌和肝转移瘤的价值
引用本文:王洋洋,王振光,李大成,武凤玉,刘思敏,薛伟.18F-FDG PET/CT诊断原发性肝癌和肝转移瘤的价值[J].中国医学影像技术,2015,31(1):77-81.
作者姓名:王洋洋  王振光  李大成  武凤玉  刘思敏  薛伟
作者单位:青岛大学附属医院PET/CT中心, 山东 青岛 266100;青岛大学附属医院PET/CT中心, 山东 青岛 266100;青岛大学附属医院PET/CT中心, 山东 青岛 266100;青岛大学附属医院PET/CT中心, 山东 青岛 266100;青岛大学附属医院PET/CT中心, 山东 青岛 266100;青岛大学附属医院PET/CT中心, 山东 青岛 266100
摘    要:目的 探讨18F-FDG PET/CT在原发性肝癌和肝转移瘤诊断中的应用价值。方法 回顾性分析108例肝脏肿瘤患者临床资料、常规影像(超声、增强CT和MRI)及PET/CT资料,病灶18F-FDG浓集水平高于周围正常肝组织为诊断恶性标准。结果 108例肝脏肿瘤各种影像检查共检出194个病灶,70个肝细胞癌病灶18F-FDG PET/CT发现34个,最大标准摄取值(SUVmax)为4.95±3.86;23个胆管细胞癌病灶PET/CT发现22个,SUVmax为7.65±3.88;101个肝内转移瘤病灶PET/CT发现97个,SUVmax为9.65±5.34。18F-FDG PET/CT对肝转移瘤和胆管细胞癌的阳性检出率(96.04%和95.65%)均高于肝细胞癌(48.57%),差异均有统计学意义(P均<0.05);肝转移瘤与肝细胞癌、胆管细胞癌与肝细胞癌之间SUVmax的差异均有统计学意义(P均<0.05)。不同原发肿瘤来源的肝转移灶的SUVmax值差异无统计学意义(F=2.07,P>0.05)。结论 18F-FDG PET/CT对原发性肝癌和肝转移瘤的病灶检出率不同,病灶的SUVmax值亦存在差异;在肝脏肿瘤诊断与分期时需科学合理应用18F-FDG PET/CT。

关 键 词:肝肿瘤  肿瘤转移  正电子发射型体层摄影术  体层摄影术  X线计算机  18F氟脱氧葡萄糖
收稿时间:2014/7/22 0:00:00
修稿时间:2014/10/23 0:00:00

Value of 18F-FDG PET/CT in diagnosis of primary hepatocellular carcinoma and liver metastases
WANG Yang-yang,WANG Zhen-guang,LI Da-cheng,WU Feng-yu,LIU Si-min and XUE Wei.Value of 18F-FDG PET/CT in diagnosis of primary hepatocellular carcinoma and liver metastases[J].Chinese Journal of Medical Imaging Technology,2015,31(1):77-81.
Authors:WANG Yang-yang  WANG Zhen-guang  LI Da-cheng  WU Feng-yu  LIU Si-min and XUE Wei
Institution:PET/CT Center, the Affiliated Hospital of Qingdao University, Qingdao 266100, China;PET/CT Center, the Affiliated Hospital of Qingdao University, Qingdao 266100, China;PET/CT Center, the Affiliated Hospital of Qingdao University, Qingdao 266100, China;PET/CT Center, the Affiliated Hospital of Qingdao University, Qingdao 266100, China;PET/CT Center, the Affiliated Hospital of Qingdao University, Qingdao 266100, China;PET/CT Center, the Affiliated Hospital of Qingdao University, Qingdao 266100, China
Abstract:Objective To explore the application value of 18F-FDG PET/CT in diagnosis of primary hepatocellular carcinoma and liver metastases. Methods The clinical results and imaging findings including ultrasound, enhancement CT, MRI and PET/CT of 108 patients with liver neoplasms were retrospectively analyzed. The malignant lesion was diagnosed when 18F-FDG foci concentration level with the tumor was higher than the surrounding normal liver tissue. Results In 108 cases, a total of 194 lesions were detected by common imaging and PET/CT. Amongst 70 hepatocellular carcinomas (HCC), 18F-FDG PET/CT revealed 34 lesions, with the maximum standardized uptake value (SUVmax) was 4.95±3.86. 18F-FDG PET/CT also revealed 22 of 23 cholangiocellular carcinomas (CCC), with the SUVmax of 7.65±3.88. And 97 cases of 101 liver metastatic lesions, with the SUVmax of 9.65±5.34. The positive finding of live metastases and CCC undergoing 18F-FDG PET/CT (detection rates 96.04% and 95.65%) were higher than that of HCC (48.57%, both P<0.05). The SUVmax between liver metastases and HCC, CCC and HCC were significantly different (both P<0.05), in addition, there was no significant difference among liver metastases derived from different primary tumors (F=2.07, P>0.05). Conclusion 18F-FDG PET/CT have different accuracies for detecting primary liver neoplasms and liver metastases, which are also with different SUVmax, it is necessary to be scientific and rational use of 18F-FDG PET/CT in the diagnosis and staging of liver neoplasms.
Keywords:Liver neoplasms  Neoplasm metastasis  Positron-emission tomography  Tomography  X-ray computed  Fluorodeoxyglucose F18
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