F18—FDG PET/CT在直肠癌诊断中的价值分析(1)
摘要:目的 探讨F18-FDG PET/CT在直肠癌诊断中的价值。方法 选择临床高度怀疑直肠恶性肿瘤的患者,行F18-FDG PET/CT检查,部分患者行CT增强及2 h后的延迟扫描,筛选出检查后确诊为直肠癌的患者259例,并将所得PET/CT检查结果与临床病理结果进行回顾性对照、分析,判断PET/CT在直肠癌诊断中的价值。结果 直肠条状高代谢PET/CT诊断阳性准确率为83.52%;常规扫描后,结合餐后2 h后行局部延迟扫描,诊断准确率提高到90.11%。直肠局限性结节状高代谢灶PET/CT诊断阳性准确率为91.03%;直肠灌水并CT增强加PET延迟扫描后,准确率提高至96.79%。F18-FDG PET/CT阴性显像12例,阴性显像率为4.63% 。 结论 F18-FDG PET/CT直肠癌诊断中具有明显优势,如能恰当运用延迟扫描、直肠灌水及CT增强检查,可显著提高诊断准确率。
关键词:直肠癌:PET/CT;CT增强;延迟扫描
中图分类号:R735.3 文献标识码:A 文章编号:1006-1959(2017)16-0177-02
, 百拇医药
Value of F18-FDG and PET/CT in the Diagnosis of Rectal Cancer
MENG Wei,GUO Xiao-jun,XIAO Yong
(PET/CT Center,General Hospital of Armed Police Frontier Force,Shenzhen 518029,Guangdong,China)
Abstract:Objective To study the value of F18-FDG PET/CT in the diagnosis of rectal carcinoma.Methods The clinical suspicion of rectal cancer patients underwent F18-FDG PET/CT examination,some patients underwent CT enhanced and delayed scan after 2 h,were diagnosed in 259 cases of rectal cancer patients,and the results of PET/CT and clinical pathological results were reviewed in the analysis,value judgment of PET/CT in the diagnosis of rectal cancer.Results The positive rate of diagnosis of rectal stripe metabolic PET/CT was 83.52%.After conventional scan,local delayed scan was combined with 2 h after meal.The accuracy of diagnosis was increased to 90.11%.The positive rate of PET/CT diagnosis was 91.03% in rectal localized nodular high metabolic lesions.Rectal irrigation enhanced CT plus PET and delayed scanning, improve the accuracy to 96.79%.F18-FDG imaging in 12 cases with PET/CT negative,negative imaging rate was 4.63%.Conclusion F18-FDG has obvious advantages in the diagnosis of rectal cancer PET/CT,if the proper use of delayed scanning,rectal irrigation and CT inspection,can significantly improve the accuracy of diagnosis.
, 百拇医药
Key words:Rectal cancer;PET/CT;CT enhancement;Delayed scan
直腸癌是常见的恶性肿瘤之一,近年来一直呈持续上升的状态,目前在消化系统恶性肿瘤发病率中已达到第2位[1]。直肠癌的早期发现、早期诊断及早期治疗是关系到患者预后和生产率的关键问题。本文旨在探讨F18-FDG PET/CT在直肠癌显像诊断中的应用价值。
1资料与方法
1.1一般资料
回顾性分析2013年6月~2016年12月于我院PET/CT中心已行F18-FDG PET/CT检查的259例临床确诊直肠癌的患者影像资料。本组病例,男性172例,女性87例,年龄25~87岁,平均年龄53.45岁。临床症状有大便带血、肛门坠痛、便秘等,其中体检发现直肠占位患者16例。
, http://www.100md.com
1.2方法
所有患者均行西门子公司生产的Biography 16 PET/CT扫描仪显像。检查前禁食6~8 h,血糖控制在7.2 mmol/L以下,F18-FDG由北京原子高科广州分公司提供,放化纯度>97%,按照0.2 mci/kg静注,安静休息70~90 min;扫描电压160kV,电流为350 mA,层厚及层间距为5 mm。PET检查2 min/床位,扫描范围包括大腿中段至颅顶,PET及CT图像传送到工作站IES进行图像对位融合显示。常规扫描后,如需延迟扫描,患者正常进餐后尽量排便,2 h后行局部扫描。部分患者行肛门低张灌注生理盐水800~1000 ml,以腹胀能耐受为宜;增强造影剂为碘海醇(30 mg/ml),注射速度3.5 ml/s,剂量1.5 ml/kg。测量方法采用半定量分析与目测相结合的分析方法;在浓聚灶部位按照病灶形态勾画感兴趣去(ROI),计算机自动计算该部位的最大标准摄取值(SUVmax)。, http://www.100md.com(孟威 郭晓君 肖勇)
关键词:直肠癌:PET/CT;CT增强;延迟扫描
中图分类号:R735.3 文献标识码:A 文章编号:1006-1959(2017)16-0177-02
, 百拇医药
Value of F18-FDG and PET/CT in the Diagnosis of Rectal Cancer
MENG Wei,GUO Xiao-jun,XIAO Yong
(PET/CT Center,General Hospital of Armed Police Frontier Force,Shenzhen 518029,Guangdong,China)
Abstract:Objective To study the value of F18-FDG PET/CT in the diagnosis of rectal carcinoma.Methods The clinical suspicion of rectal cancer patients underwent F18-FDG PET/CT examination,some patients underwent CT enhanced and delayed scan after 2 h,were diagnosed in 259 cases of rectal cancer patients,and the results of PET/CT and clinical pathological results were reviewed in the analysis,value judgment of PET/CT in the diagnosis of rectal cancer.Results The positive rate of diagnosis of rectal stripe metabolic PET/CT was 83.52%.After conventional scan,local delayed scan was combined with 2 h after meal.The accuracy of diagnosis was increased to 90.11%.The positive rate of PET/CT diagnosis was 91.03% in rectal localized nodular high metabolic lesions.Rectal irrigation enhanced CT plus PET and delayed scanning, improve the accuracy to 96.79%.F18-FDG imaging in 12 cases with PET/CT negative,negative imaging rate was 4.63%.Conclusion F18-FDG has obvious advantages in the diagnosis of rectal cancer PET/CT,if the proper use of delayed scanning,rectal irrigation and CT inspection,can significantly improve the accuracy of diagnosis.
, 百拇医药
Key words:Rectal cancer;PET/CT;CT enhancement;Delayed scan
直腸癌是常见的恶性肿瘤之一,近年来一直呈持续上升的状态,目前在消化系统恶性肿瘤发病率中已达到第2位[1]。直肠癌的早期发现、早期诊断及早期治疗是关系到患者预后和生产率的关键问题。本文旨在探讨F18-FDG PET/CT在直肠癌显像诊断中的应用价值。
1资料与方法
1.1一般资料
回顾性分析2013年6月~2016年12月于我院PET/CT中心已行F18-FDG PET/CT检查的259例临床确诊直肠癌的患者影像资料。本组病例,男性172例,女性87例,年龄25~87岁,平均年龄53.45岁。临床症状有大便带血、肛门坠痛、便秘等,其中体检发现直肠占位患者16例。
, http://www.100md.com
1.2方法
所有患者均行西门子公司生产的Biography 16 PET/CT扫描仪显像。检查前禁食6~8 h,血糖控制在7.2 mmol/L以下,F18-FDG由北京原子高科广州分公司提供,放化纯度>97%,按照0.2 mci/kg静注,安静休息70~90 min;扫描电压160kV,电流为350 mA,层厚及层间距为5 mm。PET检查2 min/床位,扫描范围包括大腿中段至颅顶,PET及CT图像传送到工作站IES进行图像对位融合显示。常规扫描后,如需延迟扫描,患者正常进餐后尽量排便,2 h后行局部扫描。部分患者行肛门低张灌注生理盐水800~1000 ml,以腹胀能耐受为宜;增强造影剂为碘海醇(30 mg/ml),注射速度3.5 ml/s,剂量1.5 ml/kg。测量方法采用半定量分析与目测相结合的分析方法;在浓聚灶部位按照病灶形态勾画感兴趣去(ROI),计算机自动计算该部位的最大标准摄取值(SUVmax)。, http://www.100md.com(孟威 郭晓君 肖勇)
参见:首页 > 医疗版 > 疾病专题 > 消化内科 > 肠道疾病 > 类癌及类癌综合征 > 结、直肠癌