肾上腺转移瘤18F-FDG PET/CT的影像特征及诊断价值

目的通过分析肾上腺转移瘤18F-脱氧葡萄糖正电子发射体层摄影术(FDG PET)/CT的影像特征,评价其对肾上腺转移瘤的诊断及临床应用价值。方法对50例18F-FDG PET/CT发现肾上腺占位的肾上腺外原发恶性肿瘤患者,以正常肝脏的代谢作为参考,结合肾上腺占位的CT值、体积、最大标准摄取值(SUVmax)等对肾上腺病变性质作出综合诊断。结果 50例患者中确诊肾上腺转移瘤41例,良性肿瘤9例,PET/CT诊断的灵敏度、特异度、阳性预测值、阴性预测值、准确性分别为97.5%、78%、95.2%、87.5%、94%。肾上腺良性肿瘤CT值为(12.43±0.78)HU,肾上腺转移瘤CT值为(30.95±7.75)HU,差异有统计学意义(P<0.05),肾上腺良性肿瘤直径为(1.63±0.8)cm,肾上腺转移瘤直径为(2.59±1.48)cm,差异无统计学意义(P=0.064);肾上腺良性肿瘤SUVmax为1.7±1.29,肾上腺转移瘤SUVmax为7.56±6.59,差异有统计学意义(P=0.012)。结论 18F-FDG PET/CT对于肾上腺转移瘤的诊断具有较高的灵敏度及准确性,是一种可靠的无创性检查手段,对肾上腺肿瘤的良、恶性鉴别,临床分期具有重要的应用价值。

Image features and diagnostic valne of 18F-FDG PET/CT for adrenal metastasis

Objective To research the imaging characters of 18F-FDG PET/CT adrenal metastasis and to evaluate its diagnostic value.MethodsThere were 50 patients with malignant tumor found adrenals nodules by 18F-FDG PET/CT.The diagnosis was made by reference of metabolism of normal liver,CT value(HU),tumor diameter and FDG maximum standardized uptake values(SUVmax).ResultsOf 50 cases,41 cases were adrenal metastasis,and 9 cases were benign.The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of 18F-FDG PET/CT in diagnosis of adrenals metastasis were 97.5%,78%,95.2%,87.5% and 94% respectively.The average CT value of adrenals benign tumor was(12.43±0.78)HU,the metastasis was(30.95±7.75)HU,statistical significant difference was found between 2 groups(P=0.064).The diameter of benign tumor was(1.63±0.8)cm,the diameter of adrenal metastasis was(2.59±1.48)cm,statistical significant difference was found between 2 groups(P=0.064).SUVmax of benign tumor was 1.7±1.29,SUVmax of adrenals metastasis was 7.56±6.59,statistical significant difference was found between 2 groups(P=0.012).Conclusion18F-FDG PET/CT has high sensitivity and accurate in diagnosis of adrenal metastasis,and is valuable for clinical staging and formulating the strategies of treatment and appraisal.