PET/CT融合图像在体部转移性肿瘤中的诊断价值——与CT、SPECT或PET的比较研究

目的：通过与CT、SPECT或PET图像的对比研究，探讨PET／CT融合图像在诊断体部转移性肿瘤中的价值。方法：收集经手术或活检后病理证实的体部转移性肿瘤共19例60个病灶，所有病例均经CT、SPECT或PFT、PET／CT扫描等手段检查，其中CT检查19例，平扫9例，另10例加做增强扫描；SPECT检查11例，其余8例为PFT检查；PET／CT检查19例。分别在这些图像上观察并记录肿瘤病灶的数目、位置、大小、放射性核素分布、有无淋巴结增大或局部软组织肿胀等情况。结果：9例转移性肺癌，PET／CT检出率为100％（29／29个），SPECT或PET为86．2％（25／29个），CT为82．8％（24／29个）；7例脊柱转移性肿瘤，PET／CT检出100％（17／17个），SPECT或PET为88．2％（15／17个），CT为76．5％（13／17个）；3例转移性肝癌，检出率分别为PET／CT100％（14／14个），SPECT或PET71．4％（10／14个），CT78．6％（11／14个）。结论：CT图像能清晰显示病灶的形态、解剖部位；核医学图像如SPECT、PET可提供病灶的生物功能信息；PET／CT融合图像，既可以显示病灶的形态、结构变化，又能得到功能信息，从而提高了定位、定性诊断和鉴别生理性摄取的能力。

The diagnostic value of PET/CT fusion images in metastatic tumors of the body: research based on the comparison of CT, SPECT or PET images

Objective:To evaluate the diagnostic value of PET/CT fusion images in the research field of metastatic tumors of the body by the comparison of CT,SPECT or PET images.Methods:The analysis was based on 19 cases with 60 metastatic lesions.The final diagnoses were confirmed by surgery,biopsy and pathology.CT,SPECT or PET and PET/CT were applied in all cases.CT scanning was applied in 19 cases.Among them,there were 9 plain examinations,and on the basis of that,the other 10 cases were applied enhancement scanning.SPECT was applied in 11 cases.Among them,there were also another 8 cases which were applied PET.Combined PET/CT examinations were performed in 19 cases.PET/CT was separately compared with CT,SPECT or PET findings,and the its numbers,localization,size,the distrubution of radionuclide,the involvement of lymph node and local swelling of soft tissues of the lesions were recorded.Results: There were 9 cases of pulmonary metastasis and the detective rate of PET/CT was 100%(29/29 cases),SPECT or PET 86.2%(25/29 cases),CT 82.8%(24/29 cases);7 cases of spine metastasis and the detective rate of PET/CT was 100%(17/17 cases),SPECT or PET 88.2%(15/17 cases),CT 76.5%(13/17 cases);3 cases of hepatic metastasis,and the detective rate of PET/CT was 100%(14/14 cases),SPECT or PET 71.4%(10/14 cases),CT 78.6%(11/14 cases)respectively.Conclusion:The shape and anatomic position of metastatic lesion can be clearly detected on CT image;nuclear medicine images such as SPECT,PET can provide excellent information on functional biology.Referring to PET/CT,it is a very useful method in detecting lesions of the shape and construction,and it can also provide more functional information,localization and characterization of metastatic lesion,PET/CT image can differentiate physiologic uptake,and meanwhile promote the differentiation of its physiologic intake.