18F-FDG PET/CT和增强MSCT评价食管癌淋巴结转移

目的 探讨18F-FDG PET/CT显像和增强多层螺旋CT(MSCT)检查评价食管癌淋巴结转移的价值.方法 食管癌患者46例,均在18F-FDG PET/CT检查前1周内行MSCT检查,并在18F-FDGPET/CT检查后1周内接受手术治疗,切除组织均行病理检查.采用16层MSCT增强扫描和18F-FDG PET/CT显像检查颈、胸和上腹部,分别观察食管癌原发病灶、转移淋巴结的部位及转移淋巴结组数,其结果与病理检查结果对照.比较18F-FDG PET/CT和增强MSCT诊断食管癌淋巴结转移的灵敏度、特异性、准确性、阳性预测值和阴性预测值.结果 46例食管癌中位于上胸段6例,中胸段32例,下胸段8例.手术清除326组淋巴结,病理检查证实其中83组内有肿瘤转移.18F-FDG PET/CT与增强MSCT诊断淋巴结转移的灵敏度、特异性、准确性、阳性预测值、阴性预测值分别为83.1%(69/83),96.3%(234/243),92.9%(303/326),88.5%(69/78),94.4%(234/248)与72.3%(60/83),98.4%(239/243),91.7%(299/326),93.7%(60/64),91.2%(239/262).2种方法诊断食管癌淋巴结转移的灵敏度差异有统计学意义(P=0.022),余诊断效能指标差别无统计学意义(P均＞0.05).在诊断食管旁淋巴结转移方面,18F-FDG PET/CT与增强MSCT的灵敏度分别为79.2%(19/24)与54.2%(13/24),差异有统计学意义(P=0.031).结论 18F-FDG PET/CT诊断食管癌淋巴结转移,尤其食管旁淋巴结转移的灵敏度高于增强MSCT,但MSCT增强扫描对于发现18F-FDG PET/CT显像阴性的淋巴结转移有重要价值,两者结合应用可明显提高对食管癌淋巴结转移的判断准确性.     

18F-FDG PET/CT显像在恶性胸膜间皮瘤诊断中的价值

Objective Malignant pleural mesothelioma (MPM) is an uncommon neoplasm arising from mesothelial cells of the pleura. The prognosis is poor with median survival of 4- 12 months. The aim of this study was to evaluate the clinic value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in the diagno-sis and to staging of MPM and to determine if the mean standardized uptake value (SUVmax) of primary tumor correlates with staging and prognosis. Methods Study was conducted retrospectively including 17 pa-tients with clinical suspicion of MPM from 2002 to 2008. Twelve cases of MPM and 5 cases benign pleural pa-thology were proven by histopathology and clinical follow-up. 18F-FDG PET/CT imaging was performed 1 h af-ter injection of 7.4 MBq/kg 18F-FDG. Patients with MPM confirmed by histopatholagy were divided into two groups: with and without metastasis. PET/CT findings were analyzed to determine if SUVmax of primary tumor correlates with staging and prognosis. Receiver operating characteristic (ROC) curve of SUVmax of primary tumor was evaluated to determine if it was a predictor of metastasis and survival time. Results The difference in SUVmax between MPM and benign pleural were statistical significant (5.78±1.81 vs 2.72± 2.51, t = 2. 8, P < 0.05). The diagnostic sensitivity, specificity and accuracy of 18F-FDG PET/CT imaging for MPM were 100% (12/12) , 4/5 and 94% (16/17). All 7 cases of bone and lymph node metastases were detected by 18F-FDG PET/CT imaging. Area under the curve (AUC) was 0.80. Conclusions 18F-FDG PET/CT imaging is useful in the diagnosis and staging of MPM. High SUVmax in the primary tumor correlates well with prognosis and predication of a greater propensity to have nodal and distant metastasis.     

螺旋CT薄层扫描并MPVR重建对孤立性肺结节的诊断价值

目的:探讨螺旋CT肺薄层扫描并多层面重建对孤立性肺结节的诊断价值。方法:对86例SPN患者进行螺旋CT规范化检查,并使用多层面重建(MPVR)技术重建观察。病灶结节直径选在0.8~3.0cm,病历均经临床手术或肺穿刺活检病理证实。其中恶性59例,均为原发性肺癌,包括腺癌25例、鳞癌17例、细支气管肺泡癌10例、小细胞未分化癌7例;良性病变27例,包括结核灶13例、炎性假瘤9例、错构瘤5例。结果:86例SPN的CT征象中,分叶征和棘突或毛刺征多出现于恶性结节,与病理和随访结果对比,螺旋CT薄层扫描并MPVR重建判断肺小结节良恶性的准确率、灵敏度、特异性、阳性预测值和阴性预测值分别为75.6%、76.3%、74.1%、86.5%、58.8%。结论:SCT肺薄层扫描并MPVR重建能显示更多的SPNCT征象,对SPN的良恶性诊断有较高的诊断价值。     

18F-FDG PET/CT结合高分辨率CT对孤立性肺结节的诊断价值

目的探讨^18F-脱氧葡萄糖（FDG）PET／CT结合高分辨率CT（HRCT）对孤立性肺结节（SPN）的鉴别诊断价值。方法25例经手术病理检查或治疗随访证实的SPN（共27个）患者，同期行^18F—FDGPET／CT显像和病灶部位HRCT检查。^18F—FDGPET／CT用目测法结合半定量法判断良恶性。HRCT则根据病灶形态学特征判断良恶性。所得^18F—FDGPET／CT结果和^18F—FDGPET／CT与HRCT相结合结果分别与病理检查结果对照比较。结果27个SPN中15个恶性，12个良性。PET／CT正确诊断14个恶性和9个良性SPN。3个良性SPNPET／CT显像为阳性，其中2个经PET／CT和HRCT联合诊断为良性。联合诊断灵敏度和单纯PET／CT相同（93．3％），但特异性、阳性预测值、阴性预测值、准确性分别高于PET／CT（91．7％、93．3％、91．7％和93．7％对75．0％、82．4％、90．0％和85．2％）。结论^18F—FDGPET／CT结合HRCT是有效的无创性鉴别SPN良恶性的方法。     

18F-FDG PET-CT在卵巢癌术后监测中的应用

目的:探讨18氟-脱氧葡萄糖(18F-FDG)正电子发射计算机体层摄影(PET-CT)在卵巢癌术后监测中的应用价值。方法:16例卵巢癌患者经肿瘤细胞减灭术和术后化疗或放疗,临床完全缓解6个月以上。行18F-FDG PET-CT检查,结果与手术病理结果对照。结果:18F-FDG PET-CT发现了9例患者,有复发或转移,共发现病灶直径0.3~3.2cm 23处病灶。手术病理证实9例(56%)无假阳性,无假阴性,诊断准确率100%;诊断复发或转移灶的敏感性、特异性、准确率、阳性预测值和阴性预测值分别为78%、78%、78%、90%和58%。PET-CT显示与术中所见病灶的大小、部位均一致。结论:18F-FDGPET-CT在卵巢癌的术后监测中有很高的诊断价值。     

18F-FDG PET/CT显像在恶性胸膜间皮瘤诊断中的价值

Objective Malignant pleural mesothelioma (MPM) is an uncommon neoplasm arising from mesothelial cells of the pleura. The prognosis is poor with median survival of 4- 12 months. The aim of this study was to evaluate the clinic value of 18F-fluorodeoxyglucose (FDG) PET/CT imaging in the diagno-sis and to staging of MPM and to determine if the mean standardized uptake value (SUVmax) of primary tumor correlates with staging and prognosis. Methods Study was conducted retrospectively including 17 pa-tients with clinical suspicion of MPM from 2002 to 2008. Twelve cases of MPM and 5 cases benign pleural pa-thology were proven by histopathology and clinical follow-up. 18F-FDG PET/CT imaging was performed 1 h af-ter injection of 7.4 MBq/kg 18F-FDG. Patients with MPM confirmed by histopatholagy were divided into two groups: with and without metastasis. PET/CT findings were analyzed to determine if SUVmax of primary tumor correlates with staging and prognosis. Receiver operating characteristic (ROC) curve of SUVmax of primary tumor was evaluated to determine if it was a predictor of metastasis and survival time. Results The difference in SUVmax between MPM and benign pleural were statistical significant (5.78±1.81 vs 2.72± 2.51, t = 2. 8, P < 0.05). The diagnostic sensitivity, specificity and accuracy of 18F-FDG PET/CT imaging for MPM were 100% (12/12) , 4/5 and 94% (16/17). All 7 cases of bone and lymph node metastases were detected by 18F-FDG PET/CT imaging. Area under the curve (AUC) was 0.80. Conclusions 18F-FDG PET/CT imaging is useful in the diagnosis and staging of MPM. High SUVmax in the primary tumor correlates well with prognosis and predication of a greater propensity to have nodal and distant metastasis.     

SPECT肾动态显像在小儿先天性肾盂积水中的临床应用

目的探讨SPECT肾动态显像在诊断小儿先天性肾盂积水的价值.方法回顾性分析肾盂积水患儿30例,采用99mTc-DTPA肾动态显像方法,部分患儿静脉注射速尿,其中12例作手术前后比较.定量指标有高峰摄取率(PUR),肾血流灌注率(BPR),半排时间(T1/2)结果BPR随肾盂积水程度加重而明显下降,重度积水为16.8%±6.8%,中度积水为35.1%±6.9%,轻度积水为40.6%±9.2%.PUR在重度积水时为21.6%±12.9%.12例患儿手术后其中10例BPR明显升高,术后T1/2明显改善.结论SPECT可准确反映肾盂积水和肾功能受损程度,两者呈正相关,术后肾功能改善情况和应用速尿能正确判断集尿系统有无梗阻存在.     

正电子发射型CT图像融合示踪剂11C-胆碱对前列腺癌诊断价值的初步探讨

目的:探讨新型正电子发射型体层摄影术-X线计算机体层摄影图像融合(PET-CT)示踪剂11C-胆碱对前列腺癌的诊断价值。方法:回顾性分析24例前列腺病变患者的11C-胆碱PET-CT显像。前列腺癌12例,良性前列腺增生12例,均经组织病理学确诊,注射11C-胆碱后5min获取数据。对前列腺增生组织和前列腺癌部位分别计算标准摄取值(SUV)。结果:良性前列腺增生~(11)C-胆碱PET-CT表现为前列腺内放射性分布较均匀,轻度摄取增高或前列腺左右侧对称性结节状轻度摄取增高,平均SUV值为2.2(1.3～3.68)。前列腺癌11C-胆碱PET-CT表现为前列腺内局限性、灶状非对称性异常放射性浓聚或弥漫性不均匀性明显异常放射性摄取增高,平均SUV值8.7(2.3～29.61)。盆壁骨转移和盆腔内增大淋巴结均表现为异常放射性浓聚。结论:11C-胆碱PET-CT对前列腺癌的诊断、盆腔淋巴结转移及盆壁骨转移的检出具有较高的价值。     

系统性红斑狼疮患者垂体泌乳素及生长激素水平测定

近年来的研究表明, 垂体泌乳素(PRL)是一种对免疫功能有广泛调节作用的激素, 有报道在SLE患者中有高泌乳素血症存在.为观察垂体分泌的另一种生长激素(GH)与SLE的关系, 我们应用放射免疫分析法对35例SLE患者进行了血清PRL、GH检测, 以探讨其在SLE发病过程中的作用.     

PET-CT对非小细胞肺癌TNM分期的价值

目的探讨PET-CT显像对非小细胞肺癌（NSCLC）患者分期的价值.方法 54例非小细胞肺癌患者行全身PET-CT显像,且于检查前一周内行胸部16层螺旋CT扫描.按照国际通用的AJCC（美国癌症联合委员会）肺癌TNM分期标准对病变分别行CT、PET-CT分期,并将组织病理结果作为参照标准.结果①对照病理结果,PET-CT对NSCLC的T分期比CT准确性更高.54例肺癌T分期中,PET-CT正确分期50例,CT正确分期40例.②54例术前诊断分期的患者中,与病理符合的肺癌N分期,PET-CT50例,CT39例.PET-CT对肺癌的N分期与CT相比具有显著性差异（P＜0.01）.对肺癌N分期的敏感性、特异性、阳性预测值、阴性预测值PET-CT分别为：80.09%、97.14%、96.11%、84.70%,CT分别为：56.48%、71.02%、63.21%、64.93%.③CT发现了11例患者的17处转移,PET-CT发现了16例患者的39处转移.结论 PET-CT显像用于NSCLC的分期是一可靠的非创伤性方法,对指导肺癌的临床治疗具有重要意义.