【摘要】 目的:回顾性分析食管鳞癌术后复发转移病例的18F-脱氧葡萄糖(18F-FDG)PET/CT影像特点,探讨PET/CT监测食管癌复发转移的临床应用价值。方法:收集2009年12月—2014年12月食管鳞癌术后于本院行18F-FDG PET/CT检查的病例,对166例有复发和(或)转移的病例分析其复发或转移部位、频数及代谢程度。结果:166例患者中,局部复发45例,80%为吻合口原位复发,最大标准摄取值(SUVmax)与病灶厚度无明显相关性(P>0.05)。149例转移病例中,单纯淋巴结转移占72.5%、单纯血行转移占4.7%、混合转移占22.8%。淋巴结转移以纵隔(66.8%)、锁骨上(39.2%)、腹膜后(21.1%)、腹腔(11.4%)为多,少数出现肺门、盆腔、颈部、腋窝、内乳区淋巴结转移。血行转移以骨、肺、肝、胸膜为主,少数伴有肌肉、腹膜、脑、脾、心包、肾上腺转移。PET/CT可检出小于1.0 cm的转移淋巴结(57例),淋巴结短径大于等于1.0 cm组与小于1.0 cm组的SUVmax差异有统计学意义(P<0.01),SUVmax与淋巴结大小无明显相关性(P>0.05)。结论:食管鳞癌术后复发以吻合口局部为主,转移以淋巴结为主,少数为血行转移。PET/CT易检出复发转移病灶,在探测小于1.0 cm淋巴结转移、非常见部位淋巴结转移、远处血行转移方面独具优势。更多还原

【Abstract】 Objective: To investigate the application value of 18F-fluorodeoxyglucose(18F-FDG) PET/CT in detecting postoperative recurrence and metastasis of esophageal carcinoma. Methods: From December 2009 to December 2014, a total of 300 patients with curative resection of the esophageal carcinoma underwent PET/CT examination in our hospital. Of these patients, 166 cases diagnosed with recurrence or metastasis were enrolled in the study. Results: Among the 166 cases, local recurrence was found in 45 patients, 80% with anastomotic recurrence in situ. The maximal standardized uptake value(SUVmax) was not correlated with lesion thickness. Among 149 metastatic cases, 72.5% had simple lymph node metastasis, 4.7% had simple hematogenous metastasis, and 22.8% had lymph node metastasis and hematogenous metastasis. 18F-FDG PET/CT detected 57 cases with metastatic lymph node within 1.0 cm. There was no significance in SUVmax between metastatic lymph node <1.0 cm group and metastatic lymph node ≥1.0 cm group. SUVmax was not correlated with lymph node diameter. Conclusion: The postoperative recurrence of esophageal carcinoma is usually localized at anastomotic site, and lymph node metastasis is common. 18F-FDG PET/CT is one optional method for diagnosis of recurrence and metastasis after curative resection of esophageal carcinoma. It plays an outstanding role in detecting lymph node(<1.0 cm) metastasis, uncommon lymph node metastasis and distant hematogenous metastasis.更多还原