^(18)F-FDG PET/CT在肝转移癌及其原发灶和肝外转移灶诊断中的价值

The value of ^(18)F-FDG PET/CT in the diagnosis of liver metastases and primary tumors and other metastases outside liver metastases

目的探讨18F-FDG PET/CT在肝转移癌及其原发灶和肝外转移灶诊断中的价值。方法对61例临床或病理确诊为肝转移癌的患者进行18F-FDG PET/CT检查,对肝转移病灶、原发肿瘤病灶及肝外转移病灶进行图像分析,并分别测量其SUVmax值。结果 61例肝转移癌患者中18F-FDG PET/CT显像肝转移灶为阳性者58例(阳性率为95.1%),SUVmax值为3.2～16.0(平均5.1);47例(77.1%)为肝内多发病灶,同机CT平扫中58例(95.1%)病灶表现为稍低或低密度。原发肿瘤中胃肠道恶性肿瘤占50.8%,肺癌占24.6%;但不同原发肿瘤的肝转移灶的SUVmax值并无统计学差异。80.3%肝转移患者同时伴有肝外转移,其中胃肠道肿瘤中29%患者仅有肝转移,而肺癌则全部同时伴有肝外转移。结论 18F-FDG PET/CT在诊断肝转移癌、寻找原发灶及肝外转移灶中具有重要价值;肝转移癌多来源于消化道肿瘤及肺癌,常为多发病灶,并多同时伴有其他转移。

Objective To study the value of 18F-FDG PET/CT in the diagnosis of liver metastases and primary tumors and other metastases outside liver metastases.Methods 61 patients who were diagnosed as liver metastases and verified by clinic or pathology were underwent 18F-FDG PET / CT examination.Then the characteristics of liver metastases,primary tumor lesions and other metastases outside liver metastases on PET/ CT imagings were evaluated and SUVmax values were measured.Results The liver metastatic lesions of 58 patients were positive on PET/ CT imagings(positive rate was 95.1%).The value of SUVmax was 3.2 to 16.0 (average 5.1).47 patients (77.1%) had multifocal liver lesions,and the liver lesions of 58 patiens (95.1%) showed slightly low or low density in plain CT scan.Of all the patients,primary gastrointestinal cancer accounted for 50.8%,lung cancer for 24.6%;but the value of SUVmax of liver metastatic lesions were not statistically significant,although the primary tumors were different.Meanwhile,80.33% of patients had other metastases outside liver metastases at the same time,and 29% of patients with gastrointestinal cancer for primary tumor had only liver metastases,otherwise for lung cancer had all accompanied with other metastases outside liver metastases.Conclusions 18F-FDG PET / CT have important value in the diagnosis of liver metastases and to find the primary tumor and other metastases.The majority of liver metastases derive from gastrointestinal cancer and lung cancer,most of them have multifocal liver lesions and accompanied by other metastases outside liver metastases.