18F-FDGPETCT诊断梗阻性黄疸的价值.DOC

18F-FDG PET/CT诊断梗阻性黄疽的价值 滕才钧邓燕云韦建林崔惠勤 柳州市工人医院PET/CT中心 目的探讨l8F-FDG PET/CT在梗阻性黄疽病因诊断中的价值。方法28例梗阻性 黄疽患者根据梗阻病因分为良性梗阻组(n=ll)和恶性梗阻组(n=17),对比 分析两组患者F-FDG PET/CT的显像特征、最大标准摄取值(SUVmax)水平；比较 PET/CT、MRI诊断梗阻性黄疽的效能。结果28例患者中，胆道无或轻度扩张15 例(15/28, 53.57%),中一重度扩张13例(13/28, 46. 42%)。恶性梗阻组中, 肝门胆管癌2例、胆总管癌5例、胰头癌6例、壶腹癌4例，其中14例l8F-FDG PET/CT显像表现为梗阻部位近端高代谢结节。良性梗阻组中，胆道炎性狭窄7 例，其屮4例合并胆管结石，,8F-FDG PET/CT显像6例表现为相应梗阻部位条片 状或结节状轻度代谢增高；自身免疫性胰腺炎4例，18F-FDG PET/CT显像表现为 胰腺多节段性多发条带状或结节状肿大，代谢普遍性增高。恶性梗阻组SUV。。 (6. 88±2. 81)明显高于良性梗阻组 SUV^ (4. 20±1.70;t=3. 143, P〈0. 05)。 l8F-FDG PET/CT、MRI诊断恶性梗阻性黄疸的敏感度为94. 12% (16/17)和58. 82% (10/17)，差异有统计学意义(x M. 086 5, P=0.043),特异度为81. 82% (9/11)和 63. 64% (7/11),差异无统计学意义(x2=0. 229 2，P=0. 632)，准 确率为 89. 29% (25/28)和 60. 71% (17/28)，差异有统计学意义(x 2=4. 666 7, P=0.031)。结论18F-FDG PET/CT对梗阻性黄疽的诊断具有重要价值，对临床治 疗决策具有重要指导意义。 关键词： 梗阻性黄疸;诊断显像;正电子发射断层显像术;体层摄影术，X线计算机; 研究方 向:PET/CT影像诊断。 基金：广西壮族自治区卫生和计划生育委员会计划科研课题( Value of 18F-FDG PET/CT in diagnosis of biliary obstruction TENG Caijun DENG Yanyun WEI Jianlin CUI Huiqin PET/CT Center， Liuzhou Worker’s Hospital; Abstract： Objective To explore the diagnostic value of l8F~FDG PET/CT in biliary obstruction. Methods Totally, 28 biliary obstruction patients were divided into benign obstruction group (n=l1) and malignant obstruction group (n=17) according to the cause of obstruction. Imaging characteristics of lbF-FDG PET/CT and maximal standard uptake value (SUV隱) were compared between the two groups. Efficacy of PET/CT and MR I in the diagnosis of obstructive jaundice were compared. Results In 28 cases，no or mild dilatation of biliary tract accounted for 53. 57% (15/28)， moderate to severe dilatation of biliary tract accounted for 46.42% (13/28) . Among the malignant obstruction group, 2 cases of hilar cholangiocarcinoma, 5 cases of bile duct carcinoma, 6 cases of carcinoma of the head of pancreas，and 4 cases of ampullary carcinoma were included. 1SE-EDG PET/CT showed proximal high metabolic nodules of the obstruction site in 14 cases. Amo