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目的 通过18F-FDG PET显像在消化道良恶性肿瘤鉴别诊断和随访结果,与CT/MR和手术病理结果的对比研究,以评价PET在消化道肿瘤中的临床应用价值。方法 消化道恶性肿块13例(胰腺癌10例,直肠癌2例和肝癌1例)、良性肿块5例和恶性肿瘤(胃癌5例,直肠癌4例和肝癌1例)手术治疗后10例共28例患者进行~(18)F-FDG PET全身显像,采用双盲法将PET诊断结果与同期的CT/MR影像结果进行比较。结果 13例消化道恶性肿块PET和CT/MR均见原发灶病变,10例PET显像结果与CT/MR相同,另外3例胰腺癌患者PET显像见腹腔淋巴结和脊柱转移。5例良性消化道占位性病变PET全身显像均阴性,其中1例病例病理诊断为直肠腺瘤。10例消化恶性肿瘤术后随访中有3例PET阳性结果与CT/MR相同,4例PET全身显像阴性,另外3例PET显像见其他部位病灶。结论 ~(18)F-FDG PET显像对原发性恶性肿瘤的诊断、良恶性肿块的鉴别诊断具较高的准确性和特异性,对恶性肿瘤治疗后随访确认或排除肿瘤残留和复发以及发现全身部位的转移等具有良好的临床应用价值,其对全身转移病灶的定性和定位诊断优于CT/MR。
Objective To evaluate the clinical value of 18F-FDG PET in differential diagnosis and follow-up of benign and malignant tumors of the digestive tract, and CT/MR and pathological findings in order to evaluate the clinical value of PET in digestive tract tumors. Methods There were 13 cases of malignant masses of the digestive tract (10 cases of pancreatic cancer, 2 cases of rectal cancer, and 1 case of liver cancer), 5 cases of benign masses, and 5 cases of malignant tumors (5 cases of gastric cancer, 4 cases of rectal cancer, and 1 case of liver cancer). Twenty-eight patients underwent 18 F-FDG PET whole-body imaging. Double-blind method was used to compare the diagnostic results of PET with CT/MR images of the same period. Results PET lesions and CT/MR lesions were found in 13 cases of malignant masses of the digestive tract. The PET imaging results of 10 cases were the same as those of CT/MR. The other 3 cases of pancreatic cancer patients had abdominal lymph nodes and spine metastases. Five patients with benign lesions of the gastrointestinal tract were negative for PET whole-body imaging, and one case was pathologically diagnosed as rectal adenoma. Among the 10 patients with malignant tumors, there were 3 PET positive findings and CT/MR findings during follow-up, and 4 cases had PET whole-body imaging negative. The other 3 PET lesions showed lesions elsewhere. Conclusions ~(18)F-FDG PET imaging has high accuracy and specificity in the diagnosis of primary malignant tumors, differential diagnosis between benign and malignant tumors, follow-up confirmation or exclusion of tumor residuals and recurrences after treatment of malignant tumors. It is found that metastasis of whole body parts has good clinical application value, and its qualitative and positional diagnosis of metastatic metastases is superior to CT/MR.