^(18)-FFDGPET鉴别肾上腺良恶性肿瘤的临床价值

^(18)F-FDG PET imaging for differentiating malignant from benign lesions in patients with adrenal masses

目的 :评价18F 氟代脱氧葡萄糖正电子发射计算机断层显像 (18F FDGPET)在肾上腺病变定性诊断中的应用价值。方法 :回顾性分析 2 2例 2 8个肾上腺肿瘤患者的临床资料 ,均采用18F FDGPET显像 ,以鉴别肾上腺肿瘤为原发性抑或继发性 ,同期均行CT检查。结果 :CT检查 2 8个肿瘤中 2 2个为恶性肿瘤 (其中 6个经手术或活检证实 ,16个随访证实 ) ,6个通过活检或随访证实为良性病变。CT发现的 19个肾上腺肿瘤中 ,17个为恶性肿瘤 ,18F FDGPET显像均为阳性。18F FDGPET对肾上腺肿瘤的定性判断的灵敏度、特异度和准确度分别为 10 0 %、6 6 .7%和 92 .9%。结论 :18F FDGPET通过肿瘤的葡萄糖代谢程度来判定病变的性质 ,对肾上腺恶性病变的标准摄取率 (SUV)相对较高 ,在肾上腺肿瘤良恶性鉴别中可以提供重要的依据。

Objective:The purpose of this study was to assess the usefulness of positron emission tomography (PET) with 18 F-fluorodeoxyglucose (FDG) when differentiating benign from malignant lesions in patients with adrenal masses. Methods:A retrospective analysis was performed on 28 adrenal lesions in 22 patients ,whose 18 FDG-PET scans were done to evaluate the primary or metastatic disease. These adrenal lesions were detected on clinical follow-up or CT imaging in synchronization. Result:28 adrenal lesions detected on CT scans from 22 patients (17 men; 5 women:age range,35～47 y mean age 58±12 y ). Of the 28 lesions , 22 were determined to be malignant by surgery/ percutaneous biopsy (n=6) or CT/clinical follow-up(n=16) . 6 lesions were proven to be benign by surgery/ percutaneous biopsy (n=2) or CT/clinical follow-up(n=4). 17 adrenal tumors were known malignant in 19 lesions detected on CT scans from lung cancer patients. Abnormally increased FDG uptake was observed in all malignant lesions. In our series, 18 F-FDG PET for characterization of malignant adrenal tumor showed a sensitivity of 100%, a specificity of 66.7 % and an accuracy of 92.9 %.Conclusion: 18 F-FDG PET is a noninvasive imaging technique able to metabolically characterize adrenal tumors. 18 F-FDG PET showed excellent diagnostic performance in differentiating adrenal lesions.