头颈部肿瘤^18F-FDG PET/CT诊断价值的探讨

Diagnostic values of PET/CT fusion in head and neck cancer

目的:探讨18F-脱氧葡萄糖(FDG)PET/CT诊断头颈部肿瘤的价值。方法:21例头颈部肿瘤患者行PET/CT显像,原发灶或转移灶经病理组织学确诊。行PET/CT融合图像、PET图像和CT图像帧对帧对比分析。基于PET/CT和CT结果对21例患者进行TNM分期,比较其结果。比较PET/CT和PET的定位准确性。结果:21例患者经PET/CT共检出恶性病灶65个。其中PET与CT皆显示清楚病灶者35个,占53.9%。PET阅片有肯定诊断结论而CT难以有肯定诊断结论者24个,占36.9%。CT显示有清楚病灶而PET显示为阴性或难以确定者共6个病灶,占9.2%。PET/CT的总检出率高于PET和CT。PET/CT使8例患者TNM分期发生改变(38.1%)。PET/CT对病变定位的准确性为90.8%,总的不影响诊断的定位准确性为95.4%;PET分别为49.2%和66.2%(P<0.05)。结论:PET/CT显像能提高头颈部肿瘤的诊断、分期和定位的准确性。

OBJECTIVE：To investigate the diagnostic value of PET/CT fusion in head and neck cancer. METHODS： Twenty-one patients with head and neck cancer underwent ^18F-FDG PET/CT imaging. The primary lesions or metastasis lesions were proved by pathology. The PET/CT fusion images, PET images and CT images of the same patient were analyzed frame by frame. The TNM stage was analyzed based on PET/CT and CT. The values of PET/CT and PET for localization were evaluated. RESULTS： Sixty-five malignant lesions were detected by PET/CT in 21 patients. Among 65 lesions, 35 lesions （53.9%） were detected and displayed definitely by both PET and the plain scan of CT; 24 lesions （36.9%） were detected definitely by PET but not by the plain scan of CT; while 6 lesions （9.2%） were negative by PET but definitely by the plain scan of CT. The sensitivity of PET/CT was higher than ones of PET and the plain scan of CT alone. The changes in TNM stage occurred in 8 patients （38.1%）, based on PET/CT. The percentages of accurate localization of PET/CT and PET were 90.8% and 49.2% respectively. The percentage of not accurate localization but not influencing final diagnosis in PET/CT was 95.4%, in PET was 66.2%, P〈0.05. CONCLUSION： PET/CT can increase the accuracy of diagnose and staging for head and neck cancer, and PET/CT is superior to PET alone for accurate localization.