【摘要】 目的探讨18F-FDG PET/CT诊断肝细胞癌(HCC)及肝内胆管细胞癌(ICC)的应用价值。方法回顾性分析133例HCC患者(HCC组)和55例ICC患者(ICC组)的18 F-FDG PET/CT资料,记录病灶最大标准化摄取值(SUVmax),以病灶18F-FDG浓集水平高于周围正常肝组织为诊断恶性标准,比较2组原发灶18 F-FDG PET/CT阳性率、SUVmax值、胆管扩张发生率、癌栓发生率、淋巴结转移发生率、远处转移发生率以及淋巴结转移、远处转移不同区域的发生率差异。结果ICC组18F-FDG PET/CT阳性率(χ~2=13.887)、SUVmax值(t=-4.139)、胆管扩张发生率(χ~2=126.441)、淋巴结转移发生率(χ~2=32.727)、远处转移发生率(χ~2=30.964)、在各区域淋巴结转移及远处转移发生率均较HCC组高(P均<0.05),而癌栓发生率与HCC组差异无统计学意义(χ~2=0.054,P=0.815)。结论 18 F-FDG PET/CT鉴别诊断HCC与ICC具有重要价值。HCC的SUVmax值低于ICC。ICC较HCC更易出现病灶周围胆管扩张、发生远处转移及合并淋巴结转移。更多还原

【Abstract】 Objective To explore the value of 18 F-FDG PET/CT in diagnosis of hepatocellular carcinoma(HCC)and intrahepatic cholangiocarcinoma(ICC).Methods Clinical and PET/CT data of 133 patients with HCC(HCC group)and55 patients with ICC(ICC group)were retrospectively analyzed.The maximum standardized uptake value(SUVmax)of lesions was recorded.The lesion was diagnosed as malignant one when 18 F-FDG foci concentration level was higher than the surrounding liver tissue.The positive rate of 18 F-FDG PET/CT,SUVmax,the incidence of biliary dilatation,tumor embolus,lymph node metastasis,distant metastasis,lymph node metastasis and distant metastasis in different regions were compared between the two groups.Results The positive rate of 18 F-FDG PET/CT(χ~2=13.887),SUVmax(t=-4.139),incidence of bile duct dilatation(χ~2=126.441),lymph node metastasis(χ~2=32.727),distant metastasis(χ~2=30.964),lymph node metastasis and distant metastasis in all regions were higher in ICC group than those in HCC group(all P<0.05).The incidence of portal vein and vena cava tumor thrombi in ICC group was not significantly different with that in HCC group(χ~2=0.054,P=0.815).Conclusion 18 F-FDG PET/CT plays an important role in diagnosis and differential diagnosis of HCC and ICC.SUVmax of HCC is lower than that of ICC.Bile duct expansion around the lesion,distant metastasis and lymph node metastasis is more often occur in ICC than in HCC.更多还原