正电子发射计算机断层-CT融合显像在头颈肿瘤中的诊断价值

目的探讨^18氟-脱氧葡萄糖(18-nuorinenuorodeoxyducose，^18F-FDG)正电子发射计算机断层显像(positron emission tomography，PET)-CT融合显像在头颈肿瘤的原发灶诊断、复发的检测和诊断分析未知原发肿瘤转移癌中的诊断价值。方法27例已确诊头颈部原发肿瘤或转移癌，进行^18F-FDGPET-CT全身显像，并与临床资料对照。结果鼻咽癌组治疗前4例PET-CT均查出原发灶，其中2例确诊有颈淋巴结转移，与病理检查结果一致。鼻咽癌放疗后12例中4例PET-CT检查鼻咽部及颈部淋巴结均为阴性表现，符合临床和病理诊断；2例放疗后原发灶复发经病理检查证实，其中1例查出颈部淋巴结及全身多处转移经随访证实；6例鼻咽原发灶PET-CT检查阴性表现．但4例颈部显示淋巴结转移经病理检查证实，2例肺部、纵隔等有转移灶未经病理检查证实。未知原发肿瘤颈淋巴转移组4例患者PET-CT均检出原发灶，3例病理检查证实，另1例未经病理检查证实。其他头颈肿瘤组7例治疗后患者中，2例患者无复发转移表现，5例不同部位肿瘤检出原发部位复发或颈淋巴结转移，有4例经病理检查证实，1例放弃治疗未经病理检查证实。结论^18F-FDGPFT-CT将PET提供的肿瘤代谢图像和CT提供的解剖图像结合，对头颈原发肿瘤诊断，检测治疗后肿瘤复发，不明原因转移癌原发灶的诊断及远处转移灶的诊断具有较大的临床价值。

Clinical evaluation of 18-fluorine fluorodeoxyglucose positron emission tomography-CT imaging in head and neck tumors]

OBJECTIVE: To study the clinical value of 18-fluorine fluorodeoxyglucose (18 F-FDG) positron emission tomography (PET)-CT imaging in diagnosis and detection of primary tumors and suspicious recurrence in head and neck cancers. METHODS: Twenty-seven patients with primary tumors or metastases in head and neck underwent 18F-FDG PET-CT imaging, and compared with clinical data. RESULTS: 1. In 4 NPC diagnosed pre-radiation patients the 18F-FDG PET-CT imaging in nasopharynx was all positive, 2 of them were detected with neck lymph node metastases, which were confirmed later histopathologically. In 12 NPC cases after radiation, 4 were not found any evidence of tumor with PET-CT imaging and clinically, 4 were detected neck recurrence and confirmed histopathologically, 2 had remote metastases confirmed by other imaging, 2 were detected and confirmed recurrence in primary sites and one of them in regional and remote site. 2. In 4 neck metastatic patients with unknown primary tumor, the primary tumors were all identified, 3 of them were confirmed histopathologically. 3. Seven patients with other head and neck tumors after therapy underwent 18F-FDG PET-CT imaging. Two patients had no evidence of recurrence. Five patients were detected recurrence or metastases, 4 of them were confirmed histopathologically, one of them refused biopsy. CONCLUSIONS: With metabolic image of PET and anatomic image of CT, 18F-FDG PET-CT is a kind of very useful way in diagnosing primary tumor and detecting the recurrence and metastases in patients with head and neck tumor.