PET/CT融合显像分析恶性肿瘤

目的研究PET与CT相结合,检测恶性肿瘤及其转移灶的优势。方法对已病理确诊恶性肿瘤患者98例行PET-CT显像,图像经融合工作站处理后行18F-FDGPET-CT融合图像、PET图像和CT图像帧对帧对比分析。结果初诊者88例,具有恶性病灶396个。396个病灶中,PET与平扫CT病灶皆显示清楚,阅片医师均有肯定诊断结论者192个(48.5%);396个病灶中,PET示病灶浓聚程度高、显示清楚、有肯定诊断结论,但平扫CT所示病灶欠清楚或病灶小、易漏诊、难以有肯定诊断结论者166个(41.9%);396个病灶中,病灶处未见明显浓聚影或仅有轻度浓聚,PET显像为阴性或难定确定,而平扫CT病灶显示清楚、有肯定诊断结论者17例38个病灶,占病灶数9.6%,占病例数的19.3%。PET-CT的总体检出率高于单纯性PET和平扫CT,对病灶的显示、定位,PET-CT也明显优于单纯性PET和平扫CT。10例治疗后患者,平扫CT难以确定肿瘤残余和坏死区域,而PET-CT清楚区分残余和坏死区。结论PET-CT中平扫CT的作用不仅限于对病灶的定位,PET与平扫CT对肿瘤病灶的检出具有相互印证及互补价值,PET-CT在恶性病灶的检出、病灶的清楚显示和准确定位方面优于单纯型PET和CT,可进一步提高恶性肿瘤诊断及分期的准确性。

PET-CT fusing images analysis of malignant tumors

Objective:To explore the role of PET-CT imaging on the diagnosis of malignant and metastatic tumors. Methods:98 patients with malignant tumors were studied by PET-CT scans. The final diagnosis of the primary tumors were established according to the pathologic test and the metastasis were diagnosed by the pathologic test and combining analysis. PET-CT fusing images,PET images mid CT images of same patient were analysed frame by frame by the specific software of workstation. Results:396 malignant lesions were diagnosed in 88 cases of preliminary diagnosis,192 lesions(48.5%) of which were detected and displayed clearly by both PET and the plain scan of CT. Among 396 lesions,the lesions were detected clearly by PET with intense FDG uptake and the definitive diagnosis was easy to establish according to the PET images,but in the plain scan of CT,the lesions were obscure,equivocal,or occult and the definitive diagnosis was hard to establish in 166 lesions,occupying 41.9%.Among 396 lesions,the lesions showed mild FDG uptake or no FDG uptake and the definitive diagnosis was hard to establish according to PET images or PET was negative,but the lesions were detected clearly by the plain scan of CT and the definitive diagnosis was easy to establish according the plain scan of CT in 38 lesions of 17 cases,occupying 9.6% of lesions and 19.3% of patients. The quantity of malignancy detected by PET-CT was more than that of PET and the plain scan of CT only PET-CT was superior to PET and the plain scan of CT in the lesions display and application obviously. In 10 cases after therapy,PET-CT could identify necrosis and residual tumors easily and clearly whiles the plain scan of CT could not. Conclusion:The role of the plain scan of CT of PET-CT is not used only for lesion apposition,they can complement and comfirm each other in the detection of malignancy lesions between PET and the plain scan of CT. The integrated PET-CT is superior to PET and the plain scan of CT alone in the malignant lesion detection,lesion display and lesion apposition and can increase the accuracy of the diagnosis and staging for malignancy.