Imaging Uterine Cervical Cancer with FDG-PET/CT: Direct Comparison with PET

Purpose  To compare 2-deoxy-2-[F-18]fluoro-d-glucose–positron emission tomography (FDG-PET) and PET/computed tomography (CT) for certainty of image interpretation and for diagnostic accuracy in patients with primary and metastatic uterine cervical cancer. Materials and Methods  Images of 13 patients with cervical cancer having PET/CT examinations were reviewed retrospectively. PET and PET/CT images of all cases were read blindly and randomly by two readers. Foci of increased FDG uptake on PET or PET/CT were classified using a scoring system regarding lesion localization and characterization. PET and PET/CT findings were assessed with all clinical information available, and diagnostic accuracy was determined on a per-lesion and on a per-patient basis. Results  For both readers, PET/CT provided significantly higher frequencies of definite lesion localization (>30% higher) and definite lesion characterization (>20% higher) compared to the findings on PET alone. The improvement in lesion localization to the definite level by PET/CT provided the definite lesion characterization in at least 50% of cases. PET/CT tended to exhibit higher diagnostic accuracy than PET alone on a lesion-based analysis (92% vs. 78% in reader 1 and 92% vs. 82% in reader 2, respectively). Metastatic disease spread was, however, almost equally evaluated between PET and PET/CT. Conclusion  PET/CT was demonstrated to be useful in the definite localization and characterization of foci of increased FDG uptake, which provided its higher diagnostic accuracy than PET alone. PET/CT appears preferable to PET in the evaluation of cervical cancer, although additional study is needed.     

螺旋CT对宫颈癌治疗后复发的诊断价值

目的 探讨螺旋CT（SCT）对宫颈癌治疗后的随访价值。方法 收集宫颈癌35例，其中根治性手术切除肿瘤30例，5例未手术行放射治疗，SCT平扫和增强21例，14例平扫，回顾性分析其CT表现。结果 （1）术后肿瘤复发23例，平扫和增强均有阳性发现，但增强后能肯定诊断。（2）复发肿瘤局限于阴道残端，膀胱及/或直肠之间有8例，占34.8%，盆腔或中央复发伴侧壁复发同时存在有14例。占61.9%；远处转移5例。占21.7%;(3)5例未手术经放疗后3例显示肿瘤较前缩小，2例出现远处转移。结论 SCT检查有助于诊断宫颈癌术后肿瘤的复发和放疗后的随访，且能为宫颈癌的进一步治疗提供放疗计划。     

DSA和CT增强在肝癌术后复发诊断中的价值比较

目的:探讨肝动脉数字减影术(DSA)及CT增强在肝癌术后患者复查中的应用价值。材料与方法:收集肝癌手术切除术后的患者28例,该组患者均行肝动脉造影,其中18例行CT增强扫描,综合其临床资料,总结其DSA及CT增强表现特点,并与最终确认复发者进行比较,分析其相互关系。结果:28例肝癌术后患者中最终确诊复发者25例,复发病人中,DSA显示异常者23例,CT增强检查者中最终确诊复发者17例,CT增强显示异常者12例。结论:肝脏DSA检查对于肝癌术后复发的诊断具有较高的灵敏度和特异度,肝癌术后患者宜常规行DSA检查。     

超声造影与增强CT对肝硬化背景下肝内小结节样病灶的诊断比较和误诊分析

目的 比较超声造影(CEUS)与增强螺旋CT(CECT)对肝硬化背景下≤3 cm结节样病灶的诊断效能.方法 对74例84个肝硬化合并肝内小结节样病灶患者行CEUS及CECT检查,评估2种检查方法的诊断效能并分析其误诊原因.结果 CEUS对小结节样病灶的敏感性、特异性、准确性分别为88.6%、87.5%、88.1%,CECT对应值分别为79.5%、95.0%、86.9%(P>0.05).2种检查方法均正确诊断68个结节(33个HCC,35个良性结节),CEUS误诊10个(5个HCC,5个良性结节),CECT误诊10个(8个HCC,2个良性结节),漏诊1个,两者均误诊的有5个结节(3个HCC,2个良性结节).结论 CEUS对肝硬化背景下小结节样病灶的定性诊断价值与CECT相似,对于误诊病例,应予注意.     

增强CT扫描与FDG-SPECT/PET扫描诊断 小肺癌的比较性研究

目的:探讨增强CT扫描与FDG-SPECT/PET显像(氟-18-脱氧葡萄糖-单光子发射计算机断层/正电子发射计算机断层显像)对小肺癌诊断的意义.方法:病理证实的小肺癌11例,炎性结节5例,结核瘤2例,术前行CT增强扫描(100mg造影剂以2.5ml/s速度静脉注射)和FDG-SPECT/PET显像(FDG11.1-14.8MBq静脉注射),观察病灶CT图像强化程度及核素显像的FDG浓聚程度,将术前两种不同的扫描结果与术后的病理结果进行对照,分析两种方法对鉴别诊断小肺癌的意义,结果:11例小肺癌增强CT扫描及FDG显像均诊断正确 ,但增强CT将1例炎性假瘤误诊为肺癌,FDG将一例结核误诊为肺癌,在11例小肺癌中CT检出6例伴有纵隔淋巴结转移,FDG检出5例淋巴结转移.结论:增强CT扫描与FOG-SPECT/PET显像均能鉴别 诊断小肺癌,两者各有优势,其正确率无显著差异,两种方法结合分析将更有利于沔肺癌的鉴别诊断.     

定量分析肝脏局限性低回声小病灶的超声造影结果并与增强CT诊断的对比研究

目的 对比超声造影(CEUS)和增强CT显示呈肝局限性低回声小病灶(LSFLLs)(直径≤3 cm)血流灌注模式,旨在探讨超声造影在LSFLLs良、恶性鉴别诊断中的应用价值.方法 回顾性分析42例(58个病灶)有病理结果的LSFLLs的超声造影灌注模式,对实时超声造影图像运用时间-强度曲线进行分析,并与64 排螺旋CT增强检查结果对照.结果 LSFLLs诊断中,超声造影的检出率为93.10%,增强CT的检出率为87.93%,超声造影的准确性为92.59%,增强CT的准确性为86.27%.结论 CEUS对LSFLLs检出率优于或不低于增强CT,可有效动态地评价肝肿瘤的血管化程度,尤其对于CT扫描未显示的小病灶进行定性、定量诊断,并可进一步对血流灌注特点进行分析,超声造影对小肝癌的早期诊断具有更重要的临床意义.     

探讨CT平扫增强及MR平扫增强分别对胰腺癌的诊断价值

目的分析和研究CT平扫和增强及MR平扫和增强的应用分别对胰腺癌的诊断价值。方法选取2006-2012年我院收治的154例经确诊后的胰腺癌患者,分别采用CT平扫及CT增强、CT综合进行诊断,MR平扫、增强和综合进行诊断,将这几种扫描法按照自由组合排列的方法进行对比,诊断其对胰腺癌的灵敏度。结果 CT平扫的诊断准确性比MR平扫的诊断准确性要低,MR增强的准确性相对较高。结论 CT和MR平扫在胰腺癌的诊断中都可以使用,但CT增强或MR增强二者可以任选其一。     

Whole-Body Integrated [68Ga]PSMA-11-PET/MR Imaging in Patients with Recurrent Prostate Cancer: Comparison with Whole-Body PET/CT as the Standard of Reference

Molecular Imaging and Biology - The aim of this study was to evaluate the detection rate of [68Ga]prostate-specific membrane antigen ([68Ga]PSMA-11) positron emission tomography (PET)/magnetic...     

B超,ERCP及CT在胰头癌诊断中的价值

本文通过５１例手术病理证实为胰头癌的患者，回顾其术前Ｂ超、ＥＲＣＰ及ＣＴ的检查，并对此三项作了比较，得出Ｂ超检查优于ＥＲＣＰ及ＣＴ，其阳性率分别为７９．５％、７０％和６２．８％。三项检查如能相互结合，则可进一步提高胰腺癌的确诊率。     

F-18 FDG-PET and PET/CT Imaging of Cancer Patients

¹⁸F-FDG PET imaging diagnoses, stages, and restages many cancers with accuracies ranging form 80% to 90%. Because of the high accuracy of FDG-PET as a molecular imaging technique of disease biology, the U.S. Food and Drug Administration (FDA) has approved PET-FDG for all cancers. Fusion of both PET and CT images enhances the inherent clinical potential of both techniques and provides synergistic knowledge that is greater than the sum of information provided by each modality alone. Since the concept of PET/CT imaging only 6 years ago, state-of-the-art CT imaging technology has been combined with high-end PET systems. Acceptance and clinical use of these hybrid systems have been widespread. This nonsystematic review describes basic aspects of FDG-PET and PET/CT in cancer imaging, patient preparation and factors affecting imaging protocol.     

超声造影与CT在非霍奇金淋巴瘤脾脏浸润灶诊断中的比较

目的评价超声造影与CT在非霍奇金淋巴瘤（NHL）脾脏浸润灶诊断中的价值。 方法7例非霍奇金淋巴瘤（NHL）患者32个脾脏浸润灶首先应用常规超声观察脾内病灶的部位、范围及内部回声,然后接受超声造影检查（CEUS）,采用造影剂SonoVue和低机械指数成像技术对比脉冲序列（CPS）,观察脾内浸润灶的数量、部位、范围及造影增强特征,并与增强CT、病理学检查进行对照分析。 结果NHL脾脏浸润灶增强典型图像改变：“筛孔状”增强;无增强;“虫蚀样”增强,超声造影可清晰显示脾内浸润灶的部位、形态、范围,其显示脾内浸润灶的敏感性为100%（32/32）。增强CT可显示脾内的23个浸润灶,敏感性为71.87%（23/32）,超声造影显示此CT遗漏的9个浸润灶均〈8 mm,超声造影敏感性高于增强CT（P〈0.01）。在判断脾内浸润灶的存活情况,超声造影与病理学检查具有较好的一致性。 结论NHL脾脏浸润灶CEUS增强模式具有特征性,超声造影技术可显著提高超声对脾脏浸润灶的诊断水平,和增强CT比较具有一定的优势。     

Quantitative Assessment of Diffusion-Weighted MR Imaging in Patients with Primary Rectal Cancer: Correlation with FDG-PET/CT

Purpose  

The aim of the study was to assess correlations between parameters on diffusion-weighted imaging and 2-deoxy-2-[¹⁸F]fluoro-d-glucose–positron emission tomography/computed tomography (FDG-PET/CT) in rectal cancer.     

对比CT检查应用于早期周围型肺癌诊断作用

目的:对比CT检查应用于早期周围型肺癌诊断作用。方法:选择2017年8月-2018年8月在本院就诊的早期周围性肺癌患者56例,分别进行X线检查和CT检查,对比两种检查方式的诊断情况和转移情况。结果:在诊断情况方面,X线检查方式与CT检查方式相比,CT检查的准确率与检出病灶数量明显更高(P<0.05);在诊断转移情况方面,CT检查诊断转移情况方面明显更好(P<0.05)。结论:CT检查应用在早期肺癌临床诊断中,诊断准确率高,能够更好的为患者展开针对性治疗,值得推广应用。     

胰腺外伤的CT诊断及分型

目的：探讨胰腺外伤的CT诊断与分型。材料与方法：回顾性分析6例胰腺外伤患者的CT表现,通过所见征象的分析,初步总结出胰腺外伤的CT分型。结果：CT对6例胰腺外伤均做出了正确的诊断,其中出血水肿型1例,胰腺炎型1例,断裂型1例,假囊肿型2例,混合型1例。结论：CT检查是诊断各型胰腺外伤的最佳方法。     

小胰腺癌的CT诊断

目的　探讨小胰腺癌的CT表现。方法　回顾性分析 41例经手术病理证实的小胰腺癌的CT征象。结果　 41例中肿瘤位于胰头颈部 2 9例 ,钩突部 10例 ,体部 2例。肿瘤最大径在 2 .0～ 3 .0cm者 8例 ,1.0～ 2 .0cm者 3 0例 ,<1.0cm者 3例。平扫肿瘤呈等密度或略低密度 ,增强后呈相对低密度。多数病例伴有不同程度的肝内外胆管扩张和胰管扩张及胰腺形态改变。结论　小胰腺癌在增强CT上表现为低密度 ,螺旋CT双期增强扫描较动态增强CT扫描更有价值。     

Performance of Integrated FDG-PET/CT for Differentiating Benign and Malignant Lung Lesions -Results from a Large Prospective Clinical Trial

Purpose The purpose of the study was to evaluate prospectively whether integrated 2-deoxy-2-[¹⁸F]fluoro-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) is more accurate for determination of malignancy in newly diagnosed pulmonary lesions compared to separate interpretation of CT and FDG-PET. Procedures Two hundred and seventy-six patients with newly diagnosed lung lesions underwent FDG-PET/CT. Helical CT, FDG-PET, and FDG-PET/CT were interpreted separately to determine the performance of each imaging modality. Histopathology served as reference in all patients, and in further 60 patients, a benign lesion was verified at follow-up (mean follow-up of 1,040 days). Results Histology revealed malignant lung tumors in 216 of 276 patients. With PET and PET/CT, a significantly lower number of lesions were classified as equivocal compared to CT alone (p < 0.001). Assuming that equivocal lesions are benign, performance of diagnostic tests was as follows: sensitivity, specificity, and accuracy for CT was 94, 75, and 90%, for PET 97, 83, and 94% (p = 0.021), and for PET/CT 96, 87, and 94% (p = 0.010). Assuming that equivocal lesions are malignant, sensitivity, specificity, and accuracy for CT was 99, 37, and 86%, for PET 99, 77, and 94% (p < 0.001), and for PET/CT 98, 68, and 92% (p = 0.002). PET and PET/CT showed the highest concordance (K = 0.912; confidence interval 0.866–0.958). In lesions less than or equal to 3 cm, there was a significant difference in the performance of PET alone and multidetector row CT as well as PET/CT and multidetector row CT (p = 0.007), irrespective if equivocal findings were judged as malignant or benign. Conclusion For differentiation of benign from malignant lung lesions, integrated FDG-PET/CT imaging was significantly more accurate than CT but not FDG-PET. The addition of metabolic imaging (FDG-PET) to morphological imaging (CT) leads to an increase in specificity and significantly reduced equivocal findings and is therefore recommended to further specify newly diagnosed lung lesions. Sandra Pauls and Andreas K. Buck equally contributed. An erratum to this article can be found at     

原发性肝癌超声造影与磁共振增强表现比较研究

目的 观察原发性肝癌超声造影与磁共振增强表现的差别,并探讨出现这些差别的原因.方法 22例原发性肝癌患者经超声造影及磁共振增强检查.结果 对比观察25个结节在2种影像学检查中的图像特点,经病理证实,20例中的23个结节为肝细胞癌,另外2例中的2个结节为肝内胆管细胞癌.肝细胞癌中17个结节超声造影检查与磁共振增强扫描具有相似的增强模式.其余6个肝细胞癌结节及2个肝内胆管细胞癌结节超声造影与磁共振增强检查增强模式不同.结论 2种影像学检查手段所采用造影剂在组织内分布特征不同以及肿瘤自身结构特点不同可能是影像学表现出现差异的原因.     

多层螺旋CT双期增强扫描和CT平扫在肝微小细胞癌诊断中的价值对比

目的研究多层螺旋CT双期增强扫描和CT平扫在肝微小细胞癌诊断中的价值对比。方法回顾性分析2016年1月~2017年3月在我院住院经病理诊断为肝微小细胞癌的30例患者,他们均行多层螺旋CT双期增强扫描和CT平扫检查;对比分析两种检测对肝脏病变密度及边缘的表现,不同检查对小肝癌检出率的对比,以及对比不同时相的肿瘤和肝脏密度差值变化情况。结果肝微小细胞癌在CT平扫时80.00%为类圆形低密度影、20.00%为等密度影,56.67%增强后病灶内密度均匀、43.33%增强后病灶内密度不均匀,66.67%增强后病灶的边界清楚、33.33%增强后病灶的边界模糊;肿瘤和肝脏密度差值在平扫期最小、其次为动脉期、门脉期最大,差异均有统计学意义(P<0.05);CT平扫时微小肝癌检出率63.33%、动脉期对微小肝癌检出率93.33%、门脉期微小肝癌检出率80.00%,差异有统计学意义(P<0.05);动脉期微小肝癌检出率较CT平扫高,差异有统计学意义(P<0.05)。结论多层螺旋CT双期增强扫描检出肝微小细胞癌概率极高,有较高的诊断价值,值得临床推广。     

转移性肝癌动脉相增强的实时超声造影与增强螺旋CT比较研究

目的比较低机械指数超声造影与增强CT显示转移性肝癌动脉相血流灌注的差异。方法对72例转移性肝癌145个病灶进行低机械指数（MI〈0.2）反向脉冲谐波实时超声造影和增强CT扫描,比较转移性肝癌病灶动脉相增强的形态,定量分析肿瘤平均灰阶/肝组织平均灰阶比值,以了解病灶增强程度。结果超声造影动脉相显示40.7%的病灶为整体增强,71%的病灶为高增强,而增强CT分别为8.9%和10.3%（P〈0.01）超声造影动脉相肿瘤平均灰阶/肝组织平均灰阶比值为2.39±1.45,增强CT为0.84±0.17（P〈0.01）。结论低机械指数超声造影在显示转移性肝癌动脉相增强方面优于增强CT,可以更好地反映转移性肝癌动脉相微血管灌注情况。