论文部分内容阅读
目的探讨疗前18F-FDGPET/CT对CT或MRI显示阴性的鼻咽癌颈部散在小淋巴结(最大横断面短径≥0.5cm但<1cm、包膜完整、无中央坏死)的临床诊断价值。方法选取经病理组织学确诊、疗前CT或MRI检查可见颈部散在小淋巴结的初治鼻咽癌患者,进行头颈部或全身18F-FDGPET/CT检查;在超声引导下对散在小淋巴结进行细针穿刺活检。对比18F-FDGPET/CT显像及穿刺病理结果,计算18F-FDGPET/CT诊断符合率,分析18F-FDGPET/CT检查对N分期的影响。结果 2004年12月至2009年8月共30例患者进入本研究。根据CT或MRI诊断N0～3期分别为3例、13例、13例、1例。30例患者颈部共发现散在小淋巴结31枚,最大横断面短径为0.5～0.8cm(中位0.6cm);其中18F-FDGPET/CT显像阳性15枚,阴性16枚;穿刺病理结果显示,15枚显像阳性的小淋巴结中病理阳性13枚,阴性2枚;16枚显像阴性的小淋巴结病理均为阴性。18F-FDGPET/CT的诊断准确率、灵敏性和特异性分别为93.5%、100%和88.9%;阳性和阴性预测值分别为86.7%和100%。与基于CT或MRI的N分期比较,18F-FDGPET/CT检查示5例患者N分期升级。结论疗前18F-FDGPET/CT检查用于诊断CT或MRI显示阴性的鼻咽癌颈部散在小淋巴结有较高的准确性,有助于鼻咽癌准确分期。
Objective To investigate the clinical value of 18F-FDG PET / CT in the diagnosis of nasopharyngeal carcinoma with scattered small lymph nodes (maximal transverse diameter≥0.5cm but less than 1cm, complete capsule without central necrosis) with negative CT or MRI findings. Methods Selected nasopharyngeal carcinoma patients with nasopharyngeal carcinoma scattered in small lymph nodes on neck or neck were diagnosed by histopathology. The head and neck or whole-body 18F-FDG PET / CT examination was performed. The small lymph nodes under ultrasound guidance Fine needle biopsy. Comparing 18F-FDG PET / CT imaging and biopsy results, the coincidence rate of 18F-FDG PET / CT diagnosis was calculated, and the effect of 18F-FDG PET / CT on N staging was analyzed. Results From December 2004 to August 2009 a total of 30 patients entered the study. According to CT or MRI diagnosis of N0 ~ 3 were 3 cases, 13 cases, 13 cases, 1 case. A total of 31 small lymph nodes were found in the neck of the 30 patients. The largest transverse cross-sectional diameter was 0.5 ~ 0.8cm (median 0.6cm). Among them, 15 were positive and 16 were negative by 18F-FDG PET / CT. Fifteen pathologically positive and negative ones were found in 15 small positive lymph nodes. The pathology of 16 small negative lymph nodes was negative. The diagnostic accuracy, sensitivity and specificity of 18F-FDG PET / CT were 93.5%, 100% and 88.9% respectively; the positive and negative predictive values were 86.7% and 100% respectively. Compared with CT or MRI-based N staging, 18F-FDG PET / CT showed 5 patients with N staging upgrade. Conclusion The 18F-FDG PET / CT examination before treatment is of high accuracy in diagnosing nasopharyngeal carcinoma with small lymph nodes scattered on CT or MRI, which is helpful for the accurate staging of NPC.