18F-FDG符合线路显像对食管癌术后复发转移的诊断价值

目的 探讨^18F-脱氧葡萄糖（FDG）符合线路显像对食管癌术后复发转移的诊断价值。方法 对29例临床怀疑复发转移的食管鳞状细胞癌术后患者行^18F-FDG符合线路显像，计算其诊断复发转移灶的灵敏度、特异性和准确性，并与CT诊断结果比较。结果 29例患者中符合线路显像真阳性19例，真阴性6例，假阳性、假阴性各2例，其诊断食管癌术后复发转移的灵敏度、特异性和准确性分别为90．5％（19／21例）、75．0％（6／8例）和86．2％（25／29例）；而CT诊断的灵敏度、特异性和准确性分别为71．4％（15／21例）、87．5％（7／8例）和75．9％（22／29例）。在符合线路显像与CT检查均阳性的13例患者中，CT检出病灶20个；而符合线路显像检出27个，比CT多检出的病灶包括食管癌复发，锁骨上、纵隔和肺门淋巴结及骨转移。结论 ^18F-FDG符合线路显像对食管癌术后复发转移的诊断具有较高的临床价值，尤其在临床疑有复发转移而常规影像学检查阴性时有重要意义。

Value of 18F-FDG dual-head coincidence imaging in the diagnosis of recurrent and metastatic oesophageal carcinoma

Objective To explore the value of ~(18)F-fluorodeoxyglucose (FDG) dual-head coinci- dence imaging in the diagnosis of recurrent and metastatic oesophageal carcinoma.Methods Twenty-nine patients with oesophageal squamous cell carcinoma suspected metastasis clinically after radical oesophagecto- my were studied.The sensitivity,specificity and accuracy of dual-head coincidence imaging in detecting re- currence and metastasis were analysed and compared with CT.Results There were 19 true positive cases, 6 true negative cases,2 false positive cases and 2 false negative cases in 29 postoperative patients detected by ~(18)F-FDG dual-head coincidence imaging.The sensitivity,specificity and accuracy were 90.5% (19/ 21),75.0% (6/8) and 86.2% (25/29),while the results by CT were 71.4% (15/21),87.5% (7/8) and 75.9% (22/29) respectively.In 13 patients who were positive detected both by CT and ~(18)F-FDG, there were more lesions detected by ~(18)F-FDG than CT.The lesions detected were focal recurrence (n=2), supraclavicular,mediastinal,hilar lymph node (n=3) and bone metastases (n=3).Conclusions ~(18)F- FDG dual-head coincidence imaging has more clinical value than CT in the diagnosis of recurrent and meta- static oesophageal carcinoma.It is valuable especially in patients with suspected recurrence or metastasis clinically and with negative conventional imaging results.