脱氧葡萄糖-正电子发射断层显像在鼻咽癌放疗后鼻咽颅底病变的诊断效果研究

目的探讨脱氧葡萄糖-正电子发射断层显像（F-18-fluoro-2-deoxyglucose positron emission tomography，FDG-PET）在鼻咽癌放疗后鼻咽颅底病变中的诊断价值。方法通过9例行FDG-PET、CT和（或）MRI检查，以及内镜下鼻咽颅底病灶探查活检术的鼻咽癌放疗后患者，比较FDG-PET、CT和（或）MRI与病理活检结果。结果9例鼻咽癌放疗后患者中CT和（或）MRI提示枕骨斜坡复发7例，可疑复发2例；FDG-PET鼻咽颅底有浓聚灶9例；病理确诊复发3例，慢性炎症和（或）骨组织部分坏死6例。PDG—PET诊断准确率是33．3％（3／9），假阳性率为66．7％（6／9）。结论FDG-PET对鼻咽癌放疗后鼻咽颅底病变诊断有一定假阳性率，确诊需根据内镜下的病理诊断。

Diagnosis of recurrent or residual nasopharyngeal carcinomas in the skull base area with F-18-Fluoro-Deoxyglucose positron emission tomography

Objective To investigate the diagnostic value of F-18-fluoro-deoxygulcose positron emission tomography ( FDG-PET) for the recurrent or residual nasopharyngeal carcinomas in the skull base area. Methods Nine post-irradiation nasopharyngeal carcinoma patients did FDG-PET scanning, CT/MRI imaging and underwent nasopharyx and skull base-biopsy under endoscopy. The results of FDG-PET were evaluated and compared with CT/MRI studies and biopsies. Results In 9 cases of post-irradiation nasopharyngeal carcinoma, CT/MRI detected 7 recurrent cases and 2 suspected recurrent cases in occipital bone and clivus. All 9 cases had accumulated FDG in nasopharynx and cranial base. A definite diagnosis was made by biopsy, 3 cases were confirmed recurrence, and others 6 cases were proved mucous chronic inflammation and (or) osteoradionecrosis. The accuracy of FDG-PET was 33.3% (3/9), and the flase positive rate was 66. 7% (6/9) . Conclusions Diagnosis of recurrent or residual nasopharyngeal carcinomas in the skull base area with FDG-PET had high false-positive rate, final diagnosis must depend on histopathologic examination under endoscopy.