脱氧葡萄糖-正电子发射断层显像在鼻咽癌放疗后鼻咽颅底病变的诊断效果研究

Diagnosis of recurrent or residual nasopharyngeal carcinomas in the skull base area with F-18-Fluoro-Deoxyglucose positron emission tomography

目的探讨脱氧葡萄糖-正电子发射断层显像(F-18-fluoro-2-deoxyglucose positron emission tomography,FDG-PET)在鼻咽癌放疗后鼻咽颅底病变中的诊断价值。方法通过9例行FDG—PET、CT和(或)MRI检查,以及内镜下鼻咽颅底病灶探查活检术的鼻咽癌放疗后患者,比较FDG—PET、CT和(或)MRI与病理活检结果。结果9例鼻咽癌放疗后患者中CT和(或)MRI提示枕骨斜坡复发7例,可疑复发2例;FDG-PET鼻咽颅底有浓聚灶9例;病理确诊复发3例,慢性炎症和(或)骨组织部分坏死6例。PDG-PET诊断准确率是33．3％(3／9),假阳性率为66．7％(6／9)。结论FDG—PET对鼻咽癌放疗后鼻咽颅底病变诊断有一定假阳性率,确诊需根据内镜下的病理诊断。

Objective To investigate the diagnostic value of F-18-fluoro-deoxygulcose positron emission tomography （FDG-PET） for the recurrent or residual nasopharyngeal carcinomas in the skull base area. Methods Nine post-irradiation nasopharyngeal carcinoma patients did FDG-PET scanning, CT/MRI imaging and underwent nasopharyx and skull base-biopsy under endoscopy. The results of FDG-PET were evaluated and compared with CT/MRI studies and biopsies. Results In 9 cases of post-irradiation nasopharyngeal carcinoma, CT/MRI detected 7 recurrent cases and ：2 suspected recurrent cases in occipital bone and clivus. All 9 cases had accumulated FDG in nasopharynx and cranial base. A definite diagnosis was made by biopsy, 3 cases were confirmed recurrence, and others 6 cases were proved mucous chronic inflammation and（or）osteoradionecrosis. The accuracy of FDG-PET was 33. 3% （3/9）, and the flase positive rate was 66.7 % （6/9）. Conclusions Diagnosis of recurrent or residual nasopharyngeal carcinomas in the skull base area with FDG-PET had high false-positive rate, final diagnosis must depend on histopathologic examination under endoscopy.