目的 通过分析良恶性腹膜病变的18F-FDG PET/CT特点,探讨18F-FDG PET/CT用于良恶性腹膜疾病的价值。方法 回顾性分析经病理确诊的107例(恶性72例,良性35例)腹膜病变患者18F-FDG PET/CT表现,测定腹膜SUVmax值(SUVp)、腹水SUVmax值(SUVa),SUVa作为靶组织(Target,T),测量肝脏SUVmax值作为非靶组织(Non-Target,NT),计算T/NT值;观察壁腹膜、大网膜、肠系膜形态改变及腹水情况。结果 良恶性腹膜病变患者的性别比例无明显统计学差异,恶性病变患者的年龄高于良性患者,差异有统计学意义;恶性病变的SUVp值高于良性,差异有统计学意义。良恶性病变壁腹膜及大网膜形态改变差异有统计学意义,壁腹膜呈多发结节状改变或弥漫性不均匀增厚,大网膜呈污垢样及饼状改变有助于恶性腹膜病变诊断;肠系膜形态的改变在两者之间无明显统计学差异;107例患者均有中大量腹水,通过分析SUVa、T/NT值及CT值发现,恶性病变SUVa、T/NT高于良性病变,差异有统计学意义,恶性腹腔积液CT值低于良性病变,差异有统计学意义;SUVp、SUVa、T/NT及CT值的ROC曲线下面积分别为0.654、0.720、0.859、0.334,表明前三者对腹膜病变有较高的诊断价值,且T/NT诊断效能最高。结论 18F-FDG PET/CT在腹膜病变中的应用价值较大,可较好地鉴别良恶性。
Abstract
Objective To analyze the characteristics and diagnostic value of 18F-FDG PET/CT imaging in benign and malignant peritoneal diseases. Methods 18F-FDG PET/CT manifestations of 107 patients (72 malignant cases and 35 benign cases) pathologically diagnosed with peritoneal lesions were retrospectively analyzed. Peritoneal SUVmax (SUVp) and ascites SUVmax (SUVa) were measured. SUVa was measured as a target tissue (Target, T) while SUVmax of the liver was measured as a non-target tissue (NT). T/NT value was calculated. The morphological changes of the parietal peritoneum, omentum, mesentery and the amounts of ascites were observed. Results There was no statistically significant difference in the sex ratio between patients with benign peritoneal lesions and those with malignant ones. Patients with malignant lesions were older than those with benign ones, with statistically significant difference. The SUVp of malignant lesions was significantly higher than that of benign ones. There were significant differences in the morphological changes of the parietal peritoneum and omentum between benign and malignant lesions. The parietal peritoneum presented multiple nodular changes or diffuse uneven thickening. The fouling and cake shape changes of the omentum could facilitate the diagnosis of malignant lesions. There was no significant difference in mesenteric morphology between the parietal peritoneum and the omentum. All the 107 patients had moderate to large amounts of ascites. It was found that SUVa and T/NT values of malignant lesions were significantly higher than those of benign lesions. The CT value of malignant ascites was significantly lower than that of benign ascites. The area under the ROC curve of SUVp, SUVa, T/NT and CT values was 0.654, 0.720, 0.859 and 0.334, respectively, indicating that the former three were of high value in the diagnosis of peritoneal lesions, with the highest T/NT diagnostic efficacy. Conclusions 18F-FDG PET/CT is well applicable to peritoneal lesions, which can better differentiate benign ones from malignant ones.
关键词
腹膜病变 /
良恶性 /
体层摄影术 /
发射型计算机 /
体层摄影术 /
X线计算机 /
脱氧葡萄糖
Key words
peritoneal lesions /
benign or malignant /
tomography /
emission-computer /
tomography /
X-ray computer /
deoxyglucose
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