PET/CT在诊断口腔颌面部肿瘤颈淋巴结转移中的价值

目的:通过与MRI检查比较,评价PET/CT(integrated PET-CT system)在诊断口腔颌面部肿瘤颈部淋巴结转移中的临床价值.方法:前瞻性分析2008-2011年47例口腔颌面部肿瘤患者,于术前2周内分别进行PET/CT、MRI检查.分别获取PET/CT影像和MRI影像.以病理结果为金标准,分析2种方法判断颈部淋巴结转移的敏感度、特异度及准确率方面的差异.采用SPSS13.0软件包对数据进行x2检验.结果:PET/CT、MRI判定颈淋巴结转移的敏感度分别为89.5％和73.7％(P＜0.05);特异度分别为89.3％和78.6％(P＞0.05);准确率分别为89.4％和76.6％(P＜0.05).结论:PET/CT在口腔颌面部肿瘤颈部淋巴结转移判定中的敏感度及准确率均优于MRI,差异具有统计学意义;PET/CT在口腔颌面部肿瘤颈淋巴结转移判定中作为一种辅助诊断方法,具有重要的临床价值.

Clinical application of PET/CT for the identification of cervical lymph node metastases of oral and maxillofacialcancers

PURPOSE： To evaluate the clinical value of PET/CT in diagnosing cervical lymph node metastasis of oral and maxillofacial cancers by comparison with MRI examination. METHODS： Forty-seven patients of oral and maxillofacial cancers underwent PET/CT and MRI examination 2 weeks before surgery. PET/CT and MRI were interpreted separately to assess regional lymph node status. Histopathological analysis was used as the gold standard for assessment of the lymph node involvement. Differences in sensitivity, specificity and accuracy among the imaging modalities were analyzed by SPSS13.0 software package for Chi-square test. RESULTS： The sensitivity of PET/CT and MRI for the identification of nodal metastases was 89.5% and 73.7% separately （P〈0.05）, whereas the specificity of PET/CT and MRI was 89.3% and 78.6% separately （P〉0.05）. The accuracy of PET/CT and MRI for the detection of cervical nodal metastases was 89.4% and 76.6%, respectively（P〈0.05 ）. CONCLUSIONS： The sensitivity and accuracy of PET/CT for the detection of cervical lymph node metastases was higher than that of MRI. PET/CT can serve as a supplementary method for the identification of cervical lymph node metastases of oral and maxillofacial cancers. Supported by Guangdong Provincial Science and Technology Projeet（2008B030301182）.