【作者】 王颖晨； 赵新明； 张敬勉； 王建方； 李德志； 孙莉； 戴春暖； 张召奇； 江志华；

【Author】 Wang Ying-Chen Zhao Xin-Ming Zhang Jing-Mian Wang Jian-Fang Li De-Zhi Sun Li Dai Chun-Nuan Zhang Zhao-Qi Jiang Zhi-Hua Department of nuclear medicine, Fourth hospital of Hebei medical university, Shijiazhuang, CHINA

【机构】 河北医科大学第四医院暨河北省肿瘤医院核医学科；

【摘要】 目的:评价18F—FDG双探头符合线路图像与螺旋CT 图像融合在宫颈癌复发转移中的临床价值。方法:宫颈癌患者 22例,年龄30～66岁,平均(45．50±11．28)岁。手术后放化疗患者14例,单纯行放化疗者8例,均为病理证实(其中鳞状细胞癌20例,腺棘细胞癌、腺癌各1例)。临床可疑复发或转移而行18F-FDG双探头符合线路显像,并与CT图像行异机融合或视觉融合。行18F—FDG显像时至少1．5个月内未做放化疗。显像仪器为西门子e．Camduet双探头SPECT／PET 仪。显像结果与病理或临床随访进行对照,随访内容包括:临床表现、B超或CT、盆腔检查,有相应的临床表现和至少2 项其他检查同时异常为复发。结果:22例宫颈癌患者中,在 CT与18F—FDG显像相同的扫描范围内,共检出病变25处。 18F—FDG符合线路图像与CT图象融合诊断复发或转移灶24 处,而CT诊断22处。真阴性6处,18F—FDG符合线路显像示全身均未见异常放射性分布,而CT显示异常3处。18F—FDG 符合线路显像与CT图像融合对宫颈癌复发转移灵敏度、特异性、准确性、阳性预测值,阴性预测值分别为96％(24／25), 100％(6／6),96．8％(30／31),100％(24／24),85．7％(6／7),而单纯CT诊断宫颈癌复发转移的灵敏度、特异性、准确性、阳性预测值、阴性预测值分别为88％(22／25),50％(3／6),88％ (22／25),50％(3／6),80．6％(25／3 1)。结论:18F—FDG符合线路图像与螺旋CT图像融合对宫颈癌复发转移灶进行定性、定位诊断有较高的临床价值。更多还原

【Abstract】 Objective: To evaluate the clinical value of fusion of 18F-fluorodeoxyglucose (FDG) coincidence imaging and CT in the diagnosis of cervix carcinoma recurrence and metastases. Methods: 22 patients (age 45.50 ± 11.28 years) with cervix carcinoma were confirmed with pathology (20 squamous cell carcinoma , 1 adenocarci-noma , 1 squamous-adenocarcinoma ). Among them, 14 postoperative patients underwent operation and then radiochemotherapy, 8 patients underwent radiochemoth-erapy alone. All patients clinically suspected recurrence or metastases, 18F- FDG dual-head coincidence (DHC) imaging, and image fusion of 18F-FDG coincidence image and CT image was done by 3D image fusion software (syngo, Siemens). The final diagnosis of recurrence or metastases was proved by pathology or clinical follow-up. The following-up included symptom, ultrasound (CT), and medical examination. It was considered recurrence or metastases when any two items of following-up results were abnormal. The results of fusion imaging were compared with the final results. Results: In the same scan region of 18F- FDG imaging and CT, 25 malignant lesions were found in 16 patients in the study. 24 malignant lesions were positive by the fusion of 18F-FDG imaging and CT, and 22 of 25 malignant lesions showed positive by CT alone. There are 6 lesions were true negative in this study, the FDG imaging showed negative but 3 lesions of them CT showed false positive. The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of 18F- FDG coincidence imaging and CT for the diagnosis of cervix recurrence and metastasis were 96.0% (24/25), 100% (6/6), 96.8%(30/31), 100%(24/24), 85.7%(6/7), respectively. Those of CT scan were 88%(22/25), 50%(3/6), 88%(22/25), 50%(3/6) 80.6%(25/31), respectively. Conclusion: The fusion of 18F-FDG coincidence image and CT has a higher clinical value in detecting cervix carcinoma recurrent and metastasis.更多还原