PET和CT对结直肠癌复发、转移诊断价值的评估

目的：评价PET和CT诊断复发转移性结直肠癌的价值。方法：结直肠癌病人94例行PET检查，其中67例同时行CT检查。以病理或随访为最后诊断，平均随访时间为21个月。^18F-FDG-PET的诊断结果基于医师的肉眼判断、SUV值（the standard uptake value）和CT图像三者结果而得出的。结果：PET和CT检查真阳性分别为46例和32例，真阴性25例和14例，假阳性5例和7例，假阴性4例和10例。PET和CT的符合率88．75％和73．02％、灵敏度92．00％和76．19％，特异性83．33％和66．67％，阳性预测值90．20％和82．05％，阴性预测值86．21％和58.33％。两者诊断符合率和灵敏度差异具有统计学意义P值分别为0．015和0．034。PET对临床处理的影响率为12．5％（n=10）。结论：PET结合常规诊断方法可有效地提高结直肠癌复发转移病灶诊断的准确性。

The value of PET and CT in the diagnosis and treatment of colorectal cancer

Objective To examine the value of 18F-FDG PET in patients with potentially metastatic recurrent colo-rectal cancer.Methods A total of 94 colorectal cancer patients with suspected recurrence disease were referred for positron emission tomography(PET),67 of them were referred for both positron emission tomography and CT.The results of PET and CT scan were analyzed retrospectively.Definite diagnosis was established on the basis of histopathological exami-nation and clinical follow-up study.The mean follow-up period was 21 months.Results The accuracy,sensitivity and specificity of PET and CT were 88.75% vs 73.02%,92.00% vs 76.19% and 83.33% vs 66.67%.The difference between PET and CT in respect to accuracy and sensitivity were statistically significant(P=0.015 and 0.034,respectively).Conclusions FDG-PET imaging is valuable for the differentiation of post-treatment changes from recurrent tumor,and of benign lesions from malignant(indeterminate lymph nodes,hepatic and pulmonary lesions).The additional adoption of FDG-PET to conventional imaging modalities can improve the accuracy of diagnosis.