18F-FDGPET/CT在原发性肝癌诊断中的应用研究

目的评价18F-脱氧葡萄糖（18F-FDG）PET/CT（正电子发射计算机断层扫描）诊断原发性肝癌的价值.方法分析原发性肝癌行PET/CT检查病例50例,其中病理诊断组35例,临床诊断组15例.根据18F-FDG摄取程度将病灶分为3种类型.Ⅰ型：病灶18F-FDG摄取明显高于周围正常肝组织;Ⅱ型：病灶18F-FDG摄取比周围正常肝组织稍增高;Ⅲ型：病灶18F-FDG摄取低于周围正常肝组织或无摄取.结果临床诊断中：14例为Ⅰ型,其余1例为典型Ⅱ型;病理诊断中：中分化肝细胞性肝癌（HCC）17例、低分化HCC5例和胆管细胞癌（CCC）5例为Ⅰ型,中分化肝细胞性肝癌5例及高分化肝细胞性肝癌1例为Ⅱ型,2例高分化HCC为Ⅲ型.PET/CT显像还发现了CT未发现的转移灶5个.结论18F-FDGPET/CT是诊断原发性肝癌的一种有效方法,能评价HCC的分化程度,但在Ⅲ型的诊断中,应结合11C-乙酸盐PET/CT或MRI等手段联合分析.

Application of 18F-FDG PET/CT in Diagnosis of Hepatocelluar Carcinoma

Objective To evaluate the diagnostic value of 18F-2-fluoro-2-deoxy-D-glucose（18F-FDG）PET/CTforpatients with primary livercarcinoma.Methods The PET/CTimaging of 50 patients who were diag-nosed as primary livercarcinoma by 18F-FDGPET/CT,15 cases got fromclinical diagnosis and 35 frompathologicdiagnosis.The tumors were divided into the following three types according to situation of 18F-FDGuptake,typeI： FDG uptake was significantly higher than normal liver tissue;type II： FDG uptake was a little higher than thesurrounding non-tumor liver tissue;type III：FDG uptake was similar to the surrounding non-tumor liver tissueor no uptakes.Results 14 cases of primary liver carcinoma from clinical diagnosis were type I,and the otherone was typical type II.In pathologic diagnosis cases,17 cases of moderately differentiated HCC,5 cases ofpoorly differentiated HCC,and 5 cases of CCC fell were type I,5 cases of moderately differentiated HCC and 1case of highly differentiated HCC were type II,but 2 cases well-differentiated HCC was type III.Moreover,5metastasis had not detected by CT were located by PET/CT imaging.Conclusions 18F-FDG PET/CT is a valu-able method for the diagnosis of primary liver carcinoma and the discrimination of malignant tumor frombenign fo-cal lesion,it can evaluate the degree of cell differentiation of HCC also.But in diagnosis of type III,we shouldcombine it with 11C-acetate PET/CTorMRI methods.