18F-FDG符合线路显像在胃肠间质瘤诊治中的价值

目的 探讨18 F-FDG符合线路显像在胃肠间质瘤(GIST)良恶性鉴别及其治疗后复发监测的价值.方法 回顾性分析22例经免疫组织化学证实为GIST患者,共行28例次18F-FDG符合线路显像.13例术前显像,9例术后显像,9例中2例临床予药物治疗过程中分别行4次显像.用ROI技术计算良恶性病变/正常组织放射性比值(T/B).术前良恶性病例组间T/B比较采用两样本比较t检验,并将T/B与GIST危险度分级进行等级相关分析.结果 13例术前显像呈高摄取者10例(T/B＞2.0),低摄取3例(T/B≤2.0)；病理检查证实:18F-FDG高摄取10例均为恶性(高度或中度危险),低摄取良性3例(极低或低危险度).恶性组患者T/B为5.050±2.315,与良性患者的1.533±0.503相比,差异有统计学意义(t=4.464,P＜0.001)；T/B与GIST危险度分级间存在相关性(r=0.819,P＜0.01);9例术后显像者复发或转移5例,FDG均呈高摄取,T/B均＞2.2.结论 18F-FDG符合线路显像在原发GIST良恶性的鉴别及治疗后复发或转移灶的监测中有一定应用价值.

Value of 18F-FDG coincidence imaging for the diagnosis of gastrointestinal stromal tumors

Objective To explore the value of 18F-FDG coincidence imaging for the differentiation of benign from malignant gastrointestinal stromal tumors （GIST） and identifying post-therapeutic recur- rence. Methods Twenty-two cases with pathologically Confirmed GIST were retrospectively analyzed. There were a total of 28 iSF-FDG coincidence imaging scans, including 13 patients with preoperative scans and 9 patients with postoperative scans （2 patients with an extra 3 scans during the treatment）. ROIs were drawn over the tumor （T） and contralateral/adjacent normal tissue （B）. The ratios of T/B were calculated and compared by t-test. The correlation between the ratio of T/B and the risk ranking of GIST was analyzed. Results Among the 13 patients with preoperative scans, 10 patients with high FDG uptake （T/B 〉 2. O） were confirmed as malignant by pathology and ranked as high/intermediate risk; the others with low FDG uptake （T/B ~〈2.0） were confirmed as benign and ranked as low/extremely low risk. There was significant difference between the T/B ratios of the malignant （5. 050 ±2. 315） and benign （1. 533±0. 503） lesions （ t = 4. 464, P 〈 0. 001 ）. There was significant correlation between the T/B ratio and risk ranking of GIST （ r = O. 819, P 〈 0.01 ）. Among the 9 patients with postoperative scans, recurrence or metastasis was found in 5 patients （ T/B ratio 〉 2.2）. Conclusion 18 F-FDG coincidence imaging is valuable for the differentia- tion of benign from malignant GIST and for monitoring recurrence/metastasis after treatment.