PET/CT及MSCT在联合诊断原发性肝细胞癌中的应用

Application of PET-CT and MSCT in Diagnosis of Primary Hepatocellular Carcinoma

目的：探讨联合应用PET／CT及MSCT在肝脏原发性肝细胞癌中的诊断价值。方法：收集明确诊断的原发性肝癌18例，PET及MSCT检查后进行回顾性总结分析，采用目测和半定量分析（SUV）的方法。结果：12例未经治疗之前PET阳性率83．3％（10／12），6例治疗后随访病例PET阳性率33．3％（2／6），未经治疗的MSCT阳性率91．6％（11／12），6例治疗后CT阳性率83．3％（5／6）。PET总的阳性率66．7％（12／18）；MSCT检查总的阳性率88．9％（16／18）。肝右叶8例，肝左叶4例，尾状叶1例，左右叶均累及6例；单发病灶15例，多发及弥漫性3例；放射性分布不均，边缘欠清且较模糊，SUV〉55例，SUV2．5～55例，SUV＜2．52例，无放射性分布6例。结论：PET对肝脏原发性肝癌的诊断具有一定的局限性，结合MSCT可以提高诊断的敏感性，新型特异性显像剂将是未来发展的方向。

Objective： To inquire the application of PET/CT and MSCT in diagnosis of primary hepatocellular carcinoma. Method：The data of PET/CT and MSCT of 18 cases of primary hepatocellular carcinoma diagnosed clearly was analyzed retrospectively with an observing and a half quantitative analysis （SUV）. Result：The positive rate of 12 cases pretreatment in PET/CT was 83.3% （10/12）,and 6 cases post-treatment was 33.3% （2/6）. The positive rate of 12 cases pretreatment in MSCT was 91. 6%（11/12）,and 6 cases post treatment was 83. 3%. （5/6）. The total positive rate in PET/CT was 66.7%（12/18）,and the total positive rate in MSCT was 88.9% （16/18）. 8 casesrs lesion in right lobe,and 4 cases in left lobe,and 1 case in caudate lobe,and 6 cases in right and left lobe. 15 cases were single lesion in liver,and 3 cases many and widespreads lesions in liver. The FDG distributes dispersed,and the edge of lesions obscure. 5 cases were SUV〉5,and SUV2.5～5 5 cases,and SUV〈2.5 2 cases, and 6 cases had no FDG distributed. Conclusion：PET/ CT has certainly limited in the diagnosis of primary hepatocellular carcinoma and the combined with MSCT can increase diagnostic sensitivity. The new special tracer is a direction for a future development.