摘要
目的：探讨胰腺外病变在PET/CT诊断胰腺癌中的价值。方法：回顾性分析73例因胰腺病变行PET/CT检查的病例，男52例，女21例，年龄30~78岁。手术（18例）、剖腹探查（4例）、细针穿刺（25例）和影像及临床随访（28例）证实恶性47例，良性26例，随访时间为6~17个月。初始诊断仅根据PET/CT所示胰腺原发病变的SUV值和CT征象，并将拟诊为恶性者分为肯定恶性和可疑恶性，胰腺外病变分为转移性和非转移病变，根据胰腺外病变对原发病变的诊断进行修正。分别统计胰腺外病变修正前后PET/CT的灵敏度、特异性、准确性、阳性预测值和阴性预测值。结果：PET/CT发现29例有胰腺外病变，26例为转移性病变，3例为非转移性病变，并对21例的诊断进行修正，修正前后PET/CT诊断的灵敏度、特异性、准确性、阳性预测值和阴性预测值分别为83.0%、69.2%、78.0%、83.0%、69.2%和93.6%、76.9%、87.7%、88.0%、87.0%。修正后PET/CT的6例假阳性中，3例为实性假乳头状瘤。结论：胰腺外病变，特别是转移性病变，提高了PET/CT诊断胰腺癌的准确性。实性假乳头状瘤是修正后PET/CT假阳性的主要原因之一。
Abstract
Objective: To explore the value of extra-pancreatic lesions on 18F-FDG PET/CT image in the diagnosis of pancreatic cancer. Methods: Seventy-three patients, 52 male and 21 female, suspected of having pancreatic cancer underwent 18F-FDG PET/CT scan. Surgical operation(18 cases), open abdominal surgery for exploration(4 cases), fine-needle aspiration(25 cases), imaging and clinical follow-up(28 cases), confirmed malignancy in 47 cases and benignity in 26 cases. Preliminary diagnoses were based on the SUV value and CT characteristics of the primary lesions in pancreas, and the confidential level of diagnoses as malignancy as graded as affirmative and probable. Extra-pancreatic lesions detected on 18F-FDG PET/CT image were classified as metastatic and non-metastatic, and the diagnoses were modified by extra-pancreatic lesions. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value before and after modification were calculated. Results: Extra-pancreatic lesions were identified on PET/CT image in 29 patients, among which 26 were metastatic and 3 were non-metastatic lesions. Those lesions modified the diagnoses in 21 cases. Sensitivity, specificity, accuracy, positive predictive value and negative predictive value before and after modification were 83.0%, 69.2%, 78.0%, 83.0%, 69.2% and 93.6%, 76.9%, 87.7%, 88.0%, 87.0% respectively. For the 6 false positive cases on PET/CT, 3 of them were proved to be solid pseudopapillary tumors(SPT). Conclusion: Extra-pancreatic lesions, especially metastatic lesions identified on 18F-FDG PET/CT image improved the diagnostic accuracy of pancreatic cancer. SPT was identified as the most important reason of false positive diagnoses after modification by extra-pancreatic lesions.
关键词
胰腺肿瘤 /
正电子发射断层显像术 /
体层摄影术 /
螺旋计算机
Key words
Pancreatic neoplasms /
Positron-emission tomography /
Tomography /
spiral computed
关志伟;王瑞民;刘长滨;尹大一;张锦明;徐白萱;田嘉禾.
胰腺外病变在18F-FDG PET/CT诊断胰腺癌中的价值[J]. 中国临床医学影像杂志. 2011, 22(5): 324-327
GUAN Zhi-wei;WANG Rui-min;LIU Chang-bin;YIN Da-yi;ZHANG Jin-ming;XU Bai-xuan;TIAN Jia-he.
The value of extra-pancreatic lesions on 18F-FDG PET/CT inimproving the diagnosis of pancreatic cancer[J]. Journal of China Clinic Medical Imaging. 2011, 22(5): 324-327
中图分类号：
Ｒ735.9
R817.4
Ｒ814.42
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