18F-FDG符合线路显像在胃肠间质瘤诊治中的价值

Value of 18F-FDG coincidence imaging for the diagnosis of gastrointestinal stromal tumors

目的探讨18F—FDG符合线路显像在胃肠间质瘤（GIST）良恶性鉴别及其治疗后复发监测的价值。方法回顾性分析22例经免疫组织化学证实为GIST患者，共行28例次18F—FDG符合线路显像。13例术前显像，9例术后显像，9例中2例临床予药物治疗过程中分别行4次显像。用ROI技术计算良恶性病变／正常组织放射性比值（T／B）。术前良恶性病例组间T／B比较采用两样本比较t检验，并将T／B与GIST危险度分级进行等级相关分析。结果13例术前显像呈高摄取者10例（T／B〉2．0），低摄取3例（T／B≤2．0）；病理检查证实：18F—FDG高摄取10例均为恶性（高度或中度危险），低摄取良性3例（极低或低危险度）。恶性组患者T／B为5．050±2．315，与良性患者的1．5334-0．503相比，差异有统计学意义（t=4．464，P〈0．001）；T／B与GIST危险度分级间存在相关性（r=0．819，P〈0．01）；9例术后显像者复发或转移5例，FDG均呈高摄取，T／B均〉2．2。结论18F—FDG符合线路显像在原发GIST良恶性的鉴别及治疗后复发或转移灶的监测中有一定应用价值。

Objective To explore the value of 18F-FDG coincidence imaging for the differentiation of benign from malignant gastrointestinal stromal tumors （GIST） and identifying post-therapeutic recur- rence. Methods Twenty-two cases with pathologically Confirmed GIST were retrospectively analyzed. There were a total of 28 iSF-FDG coincidence imaging scans, including 13 patients with preoperative scans and 9 patients with postoperative scans （2 patients with an extra 3 scans during the treatment）. ROIs were drawn over the tumor （T） and contralateral/adjacent normal tissue （B）. The ratios of T/B were calculated and compared by t-test. The correlation between the ratio of T/B and the risk ranking of GIST was analyzed. Results Among the 13 patients with preoperative scans, 10 patients with high FDG uptake （T/B 〉 2. O） were confirmed as malignant by pathology and ranked as high/intermediate risk; the others with low FDG uptake （T/B ~〈2.0） were confirmed as benign and ranked as low/extremely low risk. There was significant difference between the T/B ratios of the malignant （5. 050 ±2. 315） and benign （1. 533±0. 503） lesions （ t = 4. 464, P 〈 0. 001 ）. There was significant correlation between the T/B ratio and risk ranking of GIST （ r = O. 819, P 〈 0.01 ）. Among the 9 patients with postoperative scans, recurrence or metastasis was found in 5 patients （ T/B ratio 〉 2.2）. Conclusion 18 F-FDG coincidence imaging is valuable for the differentia- tion of benign from malignant GIST and for monitoring recurrence/metastasis after treatment.