PET-CT与腹部增强CT对腹膜转移瘤诊断价值的对比分析

Comparison of ISF-FDG PET-CT and abdomen enhancement CT in diagnosing peritoneal metastases

目的比较^18F-FDGPET-CT与腹部增强CT对腹膜转移瘤的诊断价值。方法2008年1月至2011年5月间对中山大学附属第一医院收治的怀疑腹膜转移瘤的97例患者进行，^18F-FDGPET-CT和腹部增强CT检查．通过病理检查及临床随访最终证实有无腹膜转移瘤．比较两种检查方法对腹膜转移瘤的诊断价值。结果97例患者中，经病理检查（88例）及临床随访（9例）证实77例有腹膜转移．20例无腹膜转移。PET-CT诊断腹膜转移瘤的敏感度为90．9％（70／77）．特异度为85．0％（17／20），准确性为89．7％（87／97）；出现3例假阳性和7例假阴性。腹部增强CT诊断腹膜转移瘤的敏感度为66．2％（51／77），特异度为80．0％（16／20），准确性为69．1％（67／97）；出现4例假阳性和26例假阴性。两种方法诊断准确率的差异有统计学意义（P〈0．05）。结论^18F-FDGPET-CT对于腹膜转移瘤的诊断价值明显高于腹部增强CT。

Objective To compare the diagnostic value of ^18SF-FDG PET-CT with abdomen contrast CT in the diagnosis of peritoneal metastases. Methods Between January 2008 and May 2011, imaging results of 97 patients with suspicious peritoneal metastases were retrospectively reviewed, and all the patients underwent both abdomen contrast CT and ^18SF-FDG PET-CT imaging. Final diagnosis was made by histopathology or follow up. Results Seventy-seven patients were verified as peritoneal metastases after pathological examination （n=88） or follow up （n=9）, while the other 20 patients were absent. The sensitivity of ^18SF-FDG PET-CT was 90.9%（70/77）, the specificity 85.0%（17/20）, and the accuracy 89.7%（87/97）. There were 3 false positive and 7 false negative. The sensitivity of contrast CT was 66.2%（51/77）, the specificity 80.0%（16/20）, and the accuracy 69.1%（67/97）. There were 4 false positive and 26 false negative. The difference in diagnostic accuracy was statistically significantly between these two methods （P〈0.05）. Conclusion The diagnostic value of ^18sF-FDG PET-CT is significantly higher than that of abdominal enhanced CT for peritoneal metastases.