PET/CT影像融合引导胰腺肿瘤穿刺活检的临床价值研究

The Clinical Value of Pancreatic Tumor Puncture and Biopsies Guided by PET/CT Image Fusion

目的探讨PET/CT影像融合技术引导经皮穿刺胰腺肿瘤的临床价值。方法回顾性分析在PET/CT融合引导下行胰腺肿瘤穿刺活检术的24例患者,分析研究PET/CT影像融合技术引导的胰腺肿瘤穿刺活检对病理诊断敏感性、准确性及围手术期不良反应影响等临床价值。结果24例穿刺靶病灶准确率100%。24例患者均通过手术病理或临床随访证实,其中恶性肿瘤21例,良性病变3例,诊断胰腺恶性肿瘤的敏感性为95.2%,特异性为100%,阳性预测值为100%,阴性预测值75%,诊断准确性为95.8%。穿刺活检术后3例出现中少量腹腔积液,3例出现术后感染性发热,1例出现轻度急性胰腺炎,1例出现少量肠周积气。结论PET/CT影像融合引导穿刺活检术具有微创、高度精准、安全可靠等优势,是常规影像引导胰腺穿刺活检的重要补充方法,具有一定的临床价值,但在辐射剂量问题和术中图像融合操作便捷性方面还有待于改进。今后还需要多中心、大样本数据进一步分析。

Objective To explore the clinical value of PET/CT image fusion technology in the percutaneous puncture of pancreatic tumor.Methods From February 2017 to August 2019,24 cases of pancreatic tumor biopsy guided by PET/CT fusion were retrospectively analyzed.The clinical value of PET/CT image fusion guided pancreatic tumor biopsy on sensitivity and accuracy of pathological diagnosis,adverse reactions during the perioperative period were analyzed.Results The accuracy rate of target lesions was 100%.All the 24 cases were confirmed by surgical pathology or clinical follow-up findings,including 21 cases of malignant tumor and 3 cases of benign lesion.The sensitivity,specificity,positive predictive value,negative predictive value and diagnostic accuracy of pancreatic cancer were 95.2%,100%,100%,75%,95.8%,respectively.There was a small amount of ascites in 2 cases,infectious fever in 3 cases,mild acute pancreatitis in 1 case,and a small amount of peri-intestinal gas in 1 case.Conclusion PET/CT image fusion-guided needle biopsy has the advantages of minimally invasive,highly accurate,safe and reliable.It is an important supplementary method for conventional image-guided pancreatic needle biopsy.It has certain clinical value.However,it has some drawbacks in radiation dose and intraoperative image fusion.The convenience of operation needs to be improved in this regard.In the future,further multi-center analysis and large sample data is needed.