摘要
目的 1、探讨PET/CT在胰腺癌与肿块型胰腺良病史鉴别诊断方面的价值。2、PET/CT对胰腺癌可行性切除评估中的价值。3、PET/CT在发现淋巴结转移,神经束膜侵犯和远处转移方面的价值。方法本文对37例经B超、CT、内镜等检查发现胰头占位但未能明确肿块性质的患者进行PET/CT扫描。收集病灶的大小、部位,局部和远处淋巴结转移状况,神经束膜侵犯情况,病变与邻近组织器官的解剖学关系以及是否出现远处转移病灶等情况;测量肿瘤大小及面积,病灶的18FSG早期最大标准化摄取值(SUVmax)。结果 24例术前考虑胰腺癌患者早期SUVmax平均值为6.38±3.84;肿瘤的大小平均3.40cm×2.64cm,假阳性4例;慢性胰腺炎7例早期SUVmax平均值为3.30±2.27;肿瘤的大小平均3.7cm×2.5cm。2例壶腹部癌患者SUVmax分别是5.4和4.2,肿瘤大小分别是:4.2cm×3.8cm和2.7cm×1.9cm;2例胰腺粘液性囊腺瘤,SUVmax分别是:0.6和0.8,肿瘤大小分别是:3.8cm×2.5cm和5.4cm×2.7cm。1例胰腺实性-假乳头状瘤,SUVmax值为6.9,肿瘤大小为6.6×4.7cm。1例十二指肠乳头癌,其SUVmax为6.9,肿瘤大小1.7cm×1.4cm。以早期SUVmax等于3.0作为胰腺良恶性病变的鉴别阈值,PET/CT诊断胰腺癌敏感度、特异性和准确性分别为87.1%(27/31例)、83.3%(5/6例)、86.5%(32/37)。PET/CT发现5例胰腺癌存在远处转移而无法施行手术治疗。结论 PET/CT显像诊断胰腺癌灵敏度、特异性以及准确性较高,在胰头癌和肿块型慢性胰腺炎的鉴别诊断中具有显著意义,并在术前胰腺癌可切除性评估起到指导性意义。
Objective 1.To evaluate the value of PET /CT in differential diagnosis of pancreatic benign lesions and pancreatic cancer.2.To evaluate the value of PET /CT in resected parcticalility of pancreatic cancer.3.To evaluate the value of PET /CT in finding lymph node metastasis,perineurial encroachment and remote metastasis.Methods Thirty seven cases with space occupying lesions of pancreatic were discovered by BUS,CT and endoscopy and the property of masses could not be identified.The FDG whole body PET /CT scan was performed in all cases.18 The size,location,area of lesions and early SUVmax were determinated.The metastases of local and distant lymph node,involvement of perineurial,neibouring tissue and organ and foci of distant metastasis were record.Results Twenty four suspected pancreatic cancer showed early SUVmax of 6.38±3.84,the Mean of the tumors＇ area was 3.40 cm×2.64 cm and there were 4 false positives.Seven cases with chronic pancreatitis showed low 18FDG uptake with early SUVmax of 3.30±2.27,the Mean of the tumors＇ area was 3.7 cm×2.5 cm.There were two cases with peri-ampullar adenocarcinoma,the SUV were 5.4 and 4.2,respectively.There were two cases with Pancreatic mucous cyst adenomas,the SUV were 0.6 and 0.8 respectively,the mean of the tumors＇ area were 3.8 cm×2.5 cm and 5.4 cm× 2.7 cm respectively.One cases was solid-pseudo papilloma of pancreas with a SUV of 6.9,the size of the tumor was 1.7 cm×1.4 cm.One case was papillary cancer of duodenum and its＇ SUVmax was 6,9,the tumor size was 1.7 ×1.4 cm.Using early SUVmax =3 as differential threshold value in the pancreatic benign and malignant lesions,the sensitivity,specificity and accuracy of the PET /CT were 87.1%,83.3%,86.5% respectively.Five cases with unresectable pancreatic cancer were found by PET /CT because of remote metastasis.Conclusions PET /CT has a good sensitivity,specificity and accuracy in diagnosing pancreatic benign tumor,especially in differentiating carcinoma of head of pancreas from chronic pancreatitis which the tumor was in the head of pancreas.And PET /CT could offer a guide for evaluating resected practicability of pancreatic cancer before operation.
出处
《岭南现代临床外科》
2011年第2期103-106,共4页
Lingnan Modern Clinics in Surgery
基金
国家科技支撑项目<胰腺癌综合治疗体系研究>
广东省科技计划项目(2007B060401034)
关键词
胰腺癌
PET/CT
鉴别诊断
切除可行性评估
Pancreatic cancer
PET /CT
Differential diagnosis
Assessment of resectability
