PET/CT与增强CT诊断头颈肿瘤颈淋巴结转移的对比研究

目的:探讨18F-脱氧葡萄糖(FDG)PET/CT显像与螺旋CT增强扫描检测头颈肿瘤淋巴结转移的临床价值。方法:13个头颈肿瘤病人在颈部手术前,行PET/CT和增强CT检查。术后病理结果作为参考标准,PET/CT与增强CT的发现以左、右颈侧为记录单位进行比较。结果:在21个颈侧清扫(8个双侧,5个单侧)中,共清扫出440个淋巴结,其中的45个颈部淋巴结转移癌分布在14个颈侧。PET/CT检测颈淋巴结转移的敏感性、特异性和准确性分别为86%、100%和90%,增强CT分别为79%、86%和81%,PET/CT诊断的敏感性和准确性均显著高于增强CT(P<0.05)。结论:PET/CT在头颈肿瘤淋巴结转移的诊断中优于增强CT。本文结果为PET/CT在临床和放射影像诊断为颈部淋巴结阴性病人中发现转移的研究提供了可行性依据。

The comparison of PET/CT with contrast -enhanced CT in the assessment of cervical lymph nodes in head and neck cancer

Objective:To compare the diagnostic accuracy of positron emission tomography/computed tomography(PET/CT)with contrast enhanced CT(CECT)alone in the initial evaluation of cervical lymph node of patients with head and neck cancer.Methods:Fifteen consecutive patients diagnosed with a head and neck cancer between September 2005 and April 2006 underwent prospectively PET/CT and CECT before neck dissection.PET/CT and CECT findings were recorded by neck side(left or right)and were compared with histopathological findings,which was the standard of reference.Results:Neck dissections(8 bilateral,5 unilateral;a total of 21 neck sides)were performed,45 of 440 dissected lymph nodes metastases.Histopathology revealed nodal metastases in 14 of 21 neck sides.The sensitivity,specificity and accuracy of PET/CT were 86%,100%,90%,respectively,whereas those of CECT were 79%,86%,81%,respectively.The sensitivity and accuracy of PET/CT in diagnosis of lymph node metastasis was significantly higher than that of CECT(P<0.05).Conclusion:PET/CT is significantly better than stand-alone CECT in the assessment of cervical lymph nodes metastasis in head and neck cancer.The result is justified start a study on the detection of metastases in patients with clinically and radiographically negative necks(N0).