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目的探讨~(18)F-FDG PET/CT显像对不明原因腹腔积液患者的诊断价值。方法回顾性分析96例不明原因腹腔积液患者的PET/CT资料,将病理及临床随访结果与PET/CT进行对照。结果 96例患者中,75例为腹膜恶性肿瘤(腹膜转移瘤69例,腹膜间皮瘤4例,假黏液瘤2例);21例为良性腹膜炎(17例腹膜结核,4例细菌性腹膜炎)。PET/CT诊断腹膜良恶性病变的灵敏度、特异度和准确率分别为94.67%(71/75)、71.43%(15/21)和89.58%(86/96)。腹膜良、恶性病变的SUV_(max)分别为7.91±4.01和6.03±3.19(t=-2.25,P<0.05)。18 F-FDG代谢范围与CT病灶范围的比较对鉴别腹膜良恶性病变差异有统计学意义(χ2=35.36,P<0.01)。结论 ~(18)F-FDG PET/CT在鉴别良恶性腹腔积液方面有重要价值,尤其是对肿瘤原发灶的检出,但在诊断腹膜结核时易引起假阳性,故应当密切结合临床资料和其他检查以减少误诊。
Objective To investigate the value of ~ (18) F-FDG PET / CT in the diagnosis of patients with unexplained ascites. Methods The PET / CT data of 96 patients with unexplained ascites were retrospectively analyzed. The pathological and clinical follow-up results were compared with PET / CT. Results Of the 96 patients, 75 were peritoneal malignancies (69 peritoneal metastases, 4 peritoneal mesotheliomas, 2 false pseudomyomas); 21 were benign peritonitis (17 peritoneal tuberculosis and 4 bacterial peritonitis) . The sensitivity, specificity and accuracy of PET / CT in the diagnosis of benign and malignant peritoneal lesions were 94.67% (71/75), 71.43% (15/21) and 89.58% (86/96), respectively. The SUV max of benign and malignant peritoneal lesions were 7.91 ± 4.01 and 6.03 ± 3.19, respectively (t = -2.25, P <0.05). The difference of 18 F-FDG metabolic range and CT lesion range was statistically significant for differentiating benign and malignant peritoneal lesions (χ2 = 35.36, P <0.01). Conclusions ~ (18) F-FDG PET / CT has important value in differential diagnosis of benign and malignant ascites, especially in the detection of primary tumor, but it is easy to cause false positive in the diagnosis of peritoneal tuberculosis. Therefore, it should be closely combined with clinical Data and other checks to reduce misdiagnosis.