【摘要】 背景与目的:既往主要依靠CT、MRI、SPE/CT、PET检查来判断鼻咽癌(nasopharyngealcarcinoma,NPC)放疗后局部复发、肿瘤残留或全身转移情况,本研究拟探讨脱氧葡萄糖-正电子发射计算机断层(FDG-PET/CT)在判断NPC放疗后局部复发及全身转移中的应用价值。方法:38例NPC均已临床确诊并经放疗后行PET/CT检查,显像时间为放疗后3～36个月,分别观察PET/CT、PET、CT图像,PET以标准摄取值SUV>2.5定为18F-FDG代谢增高。注射18F-FDG7.4MBq/kg后30min后行脑显像,1h后行全身显像,部分患者行2h延迟显像。结合CT的形态学特征和PET图像表现将38例患者观察结果分4组:(1)局部无复发、全身无转移;(2)局部有复发全身无转移;(3)局部无复发、全身有转移;(4)局部有复发、全身有转移。所有病例的最后诊断依赖于随访,随访时间6～10个月。结果:PET/CT诊断的敏感性为100%、特异性为89.5%,高于单独PET的100%和80%,明显高于单独CT的77.8%和84.2%。结论:PET/CT对NPC放疗后有无局部复发或肿瘤残留及全身转移的综合判断优于单独CT,略优于单独PET,在判断病灶是否为转移灶时,PET/CT的CT影像能提供重要的参考信息,对指导临床的诊治具有更好的帮助。更多还原

【Abstract】 BACKGROUND &OBJECTIVE:Local relapse,tumor residue, and whole bod y metastases of nasopharyngeal carcinoma (NPC) after radiotherapy were mainly conf irmed by CT, MRI, SPE/CT, and PET examinations. This study was to discuss the va lue of F-18-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (PET/CT) in detecting suspected recurrence or tumor residue, and who le body metastases of NPC after radiotherapy. METHODS: PET/CT were performed on 38 NPC patients 3-36 months after radiotherapy. The images of PET/CT, CT, and P ET were observed. PET standardized uptake value (SUV) was calculated, and SUV of >2.5 was considered as positive. The Patients were divided into 4 groups by dia gnosis: (1)no recurrence/residue, and no whole body metastases; (2) with recurre nce/residue, but no whole body metastases; (3) no recurrence/residue, but with w hole body metastases; (4) with both recurrence/residue and whole body metastases . Diagnoses of all patients were refered to the proved follow-up clinical infor mation. The following-up time was 6-10 months. RESULTS: The sensitivity, and s pecificity of PET/CT (100%,and 89.5%)were better than that of CT alone(77.8%, and 84.2%), a litter better than that of PET alone(100%,and 80.0%). CONCLUSIO NS: FDG-PET scan is a better tool than CT alone for the detection of recurrene or residue, and whole body metastases of NPC, a litter better than PET alone. PE T/CT may provide valuable information for judging whether the focus is metastasi s.更多还原