18F-FDG SPECT/CT显像与64排螺旋CT异机融合技术在胃癌诊断中的应用

目的通过对比分析18F-FDG SPECT/CT与64排螺旋CT异机融合的图像质量，探讨异机融合在胃癌诊断中的优势。 方法收集一周内分别行18F-FDG SPECT/CT和64排螺旋CT扫描的符合入选标准的35例胃癌患者，共计56枚病灶，其中包含胃部肿瘤病灶28枚、转移淋巴结病灶19枚和远处转移病灶9枚，并依此进行分组，同组中同机融合的图像与异机融合的图像进行图像质量对比，分别从病灶的大小、边界是否清晰、是否有伪影等方面进行主观综合评价、分级。两组间计数资料比较采用卡方检验。 结果在胃部肿瘤病灶组中，28枚病灶同机融合后图像质量为1、2、3级的病灶数量分别为8、14、6枚，异机融合分别为25、3、0枚；在转移淋巴结病灶组中，19枚病灶同机融合后图像质量为1、2、3级的病灶数量分别为7、5、7枚，异机融合分别为17、2、0枚；在远处转移病灶组中，9枚病灶同机融合后图像质量为1、2、3级的病灶数量分别为0、3、6枚，异机融合分别为8、1、0枚。3组中同机融合与异机融合图像质量比较差异均有统计学意义（χ2=21.875、12.452和15.000，均P < 0.05），异机融合后的图像质量优于同机融合。 结论18F-FDG SPECT/CT与64排螺旋CT异机融合的图像质量明显优于同机融合，在胃癌诊断中能提供更好的诊断依据，值得临床推广应用。

Benefits of using 18F-FDG SPECT/CT combined with the 64-multislice spiral CT in gastric cancer diagnosis

Objective To explore the advantages of heterogeneous fusion in diagnosing gastric cancer by comparing the images obtained from 18F-FDG SPECT/CT and 64-multislice spiral CT heterogeneous fusion. Methods Clinical and radiological image data were collected from 35 patients examined by both 18F-FDG SPECT/CT and 64-multislice spiral CT. All the 35 patients suffered from gastric cancer. These patients showed a total of 56 masses, which were grouped into three types, namely, gastric tumor, metastatic lymph node, and distant metastasis. The images processed by homogeneous and heterogeneous technologies were compared in terms of size, mass boundary, and image artifacts. Chi-square test was used to compare the enumeration data between the two groups. Results The gastric cancer group comprised a total of 28 cases. The number of cases with image quality of grades 1, 2, and 3 after homogeneous fusion technology was 8, 14, and 6 and that after heterogeneous fusion technology was 25, 3, and 0, respectively. The metastatic lymph node group comprised a total of 19 cases. The number of cases with image quality of grades 1, 2, and 3 after homogeneous fusion technology was 7, 5, and 7, and that after heterogeneous fusion technology was 17, 2, and 0, respectively. The distant metastasis group comprised a total of 9 cases. The number of cases with image quality of grades 1, 2, and 3 after homogeneous fusion technology was 0, 3, and 6 and that after heterogeneous fusion technology was 8, 1, and 0, respectively. Significant differences were noted between the images obtained from homogenous and heterogeneous fusion technologies, and the images obtained from the latter were better than those of the former (Χ2=21.875, 12.452, and 15.000, all P<0.05). Conclusion The heterogeneous fusion technology of 18F-FDG SPECT/CT and the 64-slice spiral CT can compensate for the deficiencies of the homogeneous fusion technology of 18F-FDG SPECT/CT in terms of display, evaluation, and metastatic detection of gastric cancer.