18F-FDG SPECT/CT显像在鼻咽癌诊断及分期中的价值

目的]评价18F-FDG符合线路显像同机CT图像融合在鼻咽癌诊断及分期中的价值.方法]27例鼻咽癌病人(初发12例、放疗后病人15例)和对照组11例进行18F-FDG SPECT显像及同机CT图像融合检查.结果]①鼻咽部恶性病灶的长径和最大面积与L/B比值呈正相关,相关系数分别为0.835和0.815(P＜0.01).②27例患者中,18F-FDG符合显像诊断鼻咽部恶性病灶的敏感性、特异性、准确率分别为100%、86.4%和92.1%;其中鉴别鼻咽癌放疗后的复发或残存分别为100%(4/4)、81.8%(9/11)和86.7%(13/15).③18F-FDG显像准确地检测原发鼻咽癌转移灶,其中2例分期上调,占(2/12)16.7%;3例分期下调,占(3/12)25%.有效地评价15例鼻咽癌病人放疗后的状况,帮助再分期.④同机CT图像融合能提供较准确的定位诊断.结论]18F-FDGSPECT显像在鼻咽癌诊断及分期中有实用价值,值得临床广泛应用.

Value of 18F-FDG SPECT/CT in Diagnosis and Staging of Patients with Nasopharyngeal Carcinoma

Objective]To assess the value of 18F-FDG SPECT/CT in the diagnosis and staging of nasopharyngeal carcinoma (NPC). Methods]Twenty-seven NPC patients (12 primary cases and 15 cases post RT) and 11 controls were underwent 18F-FDG SPECT imaging and registration with integrated CT. Results] (1) There was a positive relationship between the diameter and maximum area of malignant lesion in nasopharynx and the L/B ratio, the coefficient were 0.835 and 0.815(P < 0.01), respectively. (2) FDG SPECT imaging showed that the sensitivity, specificity, and accuracy were 100%, 86.4%, and 92.1% , respectively in diagnosing the NPC, and 100% (4/4), 81.8% (9/11) and 86.7% (13/15), respectively in diagnosing the recurrence or remains of NPC after radiotherapy. (3) 18F-FDG SPECT could accurately detect metastases in primary NPC, leading to an upstaging in 2/12 (16.7%) and a downstaging in 3/12 (25%); and effectively evaluate the condition of NPC post RT, helping restaging. (4) The image fusion with integrated X-ray CT can provide precise localization of FDG imaging. Conclusion] 18F-FDG SPECT/CT imaging had practical value in the diagnosis and staging of NPC, and worth for spread application clinically.