脱氧葡萄糖-正电子发射计算机断层显像对颈淋巴结转移癌的诊断价值

目的：探讨脱氧葡萄糖-正电子发射计算机断层^18F-FDG-PET／CT（PET／CT）]融合显像对颈淋巴结转移癌的诊断价值。方法：对照颈淋巴结清扫术后病理结果，回顾性对比分析20例头颈癌患者颈部正电子发射断层（PET）、CT及PET／CT资料。结果：PET对颈淋巴结转移癌的诊断敏感性、特异性及准确度分别为92.3％、85.7％、90.0％，CT分别为77.0％、57.1％、70.0％，PET／CT分别为92.3％、100.0％、95.0％，PET／CT的诊断准确度显著高于CT（P〈0．05）、略优于PET。13例鼻咽癌放疗后患者，CT诊断正确7例，PET／CT诊断正确12例。7例N。患者颈淋巴结清扫术后病理证实4例存在颈淋巴结转移，术前PET／CT均诊断正确。结论：PET／CT融合显像对颈淋巴结转移癌的诊断价值优于单独的PET及CT，尤其对于治疗后的患者，其诊断优势更加突出，有望作为是否需行颈淋巴结清扫术的指征。

Diagnostic value of 18F-FDG PET/CT in the detection of the cervical lymph nodes metastasis

Objective:To explore the diagnostic value of ~(18)F-FDG PET/CT in the detection of the cervical lymph nodes metastasis.Method:According to the pathological result,the data of neck PET,CT,PET/CT of 20 patients with head and neck tumors were analyzed retrospectively.Result:The sensitivity,specificity and accuracy of PET,CT and PET/CT in detection cervical lymph nodes metastasis were (92.3%,85.7%,90.0%),(77.0%,57.1%,70.0%),(92.3%,100.0%,95.0%) respectively, the accuracy of PET/CT was better than that of CT alone(P<0.05)and a little better than that of PET alone. Among 13 cases after irradiation,the correct diagnose was found in seven cases by CT and in 12 cases by PET/CT. Four cases were found with cervical lymph node metastasis in the seven clinical N_0 (cN_0) patients after functional neck dissection (FND).The preoperative diagnose of PET/CT was completely consistent with the postoperative pathological result.Conclusion:~ 18 F-FDG PET/CT is better than CT alone and PET alone for the detection of cervical lymph nodes metastasis,especially for the recurrent tumors. It may be served as the indication of neck dissection in the head and neck cancers.