18F-FDGPET／CT在腺样囊性癌术后中的应用价值

目的：探讨18F-FDGPET/CT在腺样囊性癌术后中的应用价值。方法回顾性分析2007年8月-2014年3月13例腺样囊性癌术后18F-FDGPET/CT检查图像资料，分析其特点，以提高对该病局部复发或远处转移的认识，所有病例确诊肿瘤复发、转移的依据为再次手术或穿刺病理及临床随访证实。结果13例腺样囊腺癌中，其中位于右颌下腺3例，左颌下腺2例，而位于左上唇、左侧鼻腔、右侧鼻腔、右侧蝶窦及筛窦、右上颌窦、气管下段、口底、右侧硬颚各1例。经手术病理或随访证实，局部复发2例，未见局部复发11例，PET/CT诊断复发5例，未见局部复发8例，PET/CT对术区局部复发诊断敏感性为100％，特异性为78．6％；远处转移9例，PET诊断转移7例，转移性病变诊断敏感性为77.8％，特异性为100％，其中4例改变了临床分期。其中颈部淋巴结转移3例，双肺转移4例，肝脏及骨骼多发转移1例，双肺、骨骼转移1例，同时并双肺、肝脏、骨骼多发转移1例。肿瘤局部复发病例中，SUVmax最大值为15．3，SUVmax最小值为7．4；转移性病变中，其中SUVmax最大值为15．8，SUVmax最小值为0．8。结论腺样囊性癌是一种高度侵袭性恶性肿瘤，具有生长速度慢、手术治疗后易局部复发和长期随访易发生远处转移等特点。因此，18F-FDGPET/CT一次显影全身显像，不仅对腺样囊性癌术后局部有无复发有重要诊断价值，而且对远处转移也有很好的参考意义。

The application value of 18 F-FDG PET/CT in adenoid cystic carcinoma post-operation

Objective To explore application value of 18 F-FDG PET/CT in the adenoid cystic carcinoma （ACC） post-op-eration. Methods We retrospectively analyzed the 18 F-FDG PET/CT image data of 13 cases of adenoid cystic carcinoma postoperation from August 2007 to March 2014 and analyzed their characteristics so as to raise awareness of the disease on local recurrence or distant metastasis. All recurrences and distant metastases of ACC were confirmed by postoperative his-topathology or follow up. Results Of 13 cases of ACC, 3 cases were located in the right submandibular region, 2 cases in the left submandibular region, and 1 case in the left upper lip, in the left nasal cavity, in the nasal cavity, in right sphenoid sinus and ethmoid sinus, in the maxillary sinus, 1 in the right lower trachea, 1 in the floor of the mouth, and 1 in the right hard palate. 2 cases appeared local recurrence and 11 cases were absence of local relapse as confirmed by postoperative his-topathology or follow-up. PET/CT detected the recurrence in 5 cases and no local recurrence in 8 cases. The sensitivity of PET/CT in diagnosis of local recurrence was 100% and the specificity was 78. 6%. In 9 cases with distant metastasis, PET/CT diagnosed the metastasis in 7 cases, the metastatic diagnostic sensitivity was 77. 8%, and the specificity was 100%. Clinical stage was changed in 4 cases. The neck lymph node metastasis was found in 3 cases, metastasis to the lung in 4 cases, liver and bone metastasis in 1 case, double lung and bone metastasis in 1 case, and double lung, liver, and bone metastasis in 1 case. For these cases of local recurrence, the SUVmax was 15. 3 and the SUVmin was 7. 4. As for the me-tastasis lesions, SUVmax was 15. 8 and the SUVmin value was 0. 8. Conclusion ACC is a highly aggressive malignant tumor, which possesses the features of slow growth, local recurrence after surgical treatment and tendency towards distant metastasis by long-term follow-up. Therefore, 18 F-FDG PET/CT, which is able to scan a whole-body, has not only an im