【作者】 朱旭生； 梁培炎； 李群； 邹德环； 廖国荣； 佘立群；

【Author】 ZHU Xu-sheng, LIANG Pei-yan, LI Qun, ZOU De-huan, LIAO Guo-rong, SHE Li-qun (Department of Nuclear Medicine, the First Municipal People’s Hospital of Guangzhou, Guangzhou 510180, China)

【机构】 广州市第一人民医院核医学科； 中山大学肿瘤医院；

【摘要】 目的　探讨符合线路SPECT图像融合技术对鼻咽癌的诊断价值。方法　5 2例受检者行18F FDG符合线路SPECT显像。经过全能量X线衰减校正和有序子集最大期望值法(COSEM )迭代重建后,将CT图像与核医学图(PET)进行同机图像融合,获得横断面、矢状面、冠状面三维断层图像。计算病灶与对侧相应部位的摄取比值(T/N)比值R。分别采用视觉分析和半定量分析比较18F FDG对鼻咽癌的诊断效能。结果　3 6例鼻咽癌患者18F FDG显像视觉分析阳性3 3例,ROI分析最大摄取比值达10 .5 7,最小为1.86。以摄取比值R≥1.8为判断标准,诊断鼻咽癌的灵敏度为91.7% ,特异性81.3 % ,准确性88.9%。结论　18F FDG符合线路显像及图像融合技术对鼻咽癌诊断具有高灵敏度、高特异性和高准确性,不仅鼻咽癌病灶部位能清晰定位,而且对鼻咽部周围淋巴结、颈部淋巴结、锁骨上淋巴结、腋窝淋巴结转移的诊断具有重要的意义,为临床制定治疗方案、适形放疗、照射野的确定、疗效观察和疾病分期均具有重要的临床价值更多还原

【Abstract】 Purpose To investigate the diagnostic value of 18 F-FDG coincidence SPECT on nasopharyngeal cancer. Methods 18 F-FDG coincidence SPECT imaging was performed on 52 patients.Upon whole energy X-ray attenuation correction and cosem reconstruction,we put CT to PET co-registration in the same unit,acquiring axial,sagittal and coronal three-dimensional images.Uptake ratio(R) of lesion to contralateral region was calculated.Visual analysis and semi-quantitative method were used to compare the diagnostic efficacy of 18 F-FDG upon nasopharyngeal cancer. Results 33 nasopharyngeal cancer patients were positive for 18 F-FDG imaging.The uptake ratio ranged from 1.86-10.57. If uptake ratio ≥1.8 as a threshold,the diagnostic sensitivity for nasopharyngeal cancer is 91.7%,specificity 81.3%,accuracy 92.9%;whereas for visual analysis alone,the sensitivity 91.7%, specificity 76.5% and accuracy 88.9%. Conclusion 18 F-FDG coincidence imaging is highly sensitive, specific and accurate for diagnosing nasopharyngeal cancer.Apart from clearly localizing the lesion,it also revealed lymph nodes beside the nasopharynx,lymph nodes of the neck,supraclaricular and axillary nodal metastasis.Thus it provides important clinical information for treatment planning,dimension conform radiotherapy,radio field, therapentic effect observation and clinical staging.更多还原