^18F-FDGPET／CT对肾脏肿瘤的诊断价值

The value of diagnosing kidney neoplasms with ^18F-FDG PET/CT

目的探讨^18F—FDGPET／CT对肾脏肿瘤的临床诊断价值。方法回顾性分析近5年经^18F—FDGPET／CT诊断为肾脏肿瘤且病理或临床综合诊断明确的79例患者资料，其中男52例，女27例，平均年龄（57．3±14．1）岁。PET／CT诊断根据肾脏轮廓改变、病灶密度异常及FDG摄取程度做出。计算^18F—FDGPET／CT诊断肾脏肿瘤的效能指标。结果79例中恶性肿瘤70例（包括肾细胞癌40例、肾盂癌5例，淋巴瘤8例，转移瘤16例，肾筋膜囊脂肪肉瘤1例）；良性肿瘤9例（包括血管平滑肌脂肪瘤7例，肾嗜酸细胞腺瘤1例，后肾腺瘤1例；不含小脂滴样错构瘤病例）。^18F—FDGPET／CT对病灶检出率达97．5％（77／79），对肾脏良恶性病灶判断的灵敏度为92．9％（65／70），特异性为7／9，准确性为91．1％（72／79），阳性预测值为97．0％（65／67），阴性预测值为58．3％（7／12）。结论^18F—FDGPET／CT能够检出并判断大部分肾脏占位病变性质，对肾脏肿瘤患者进行全身检查并做出综合评价是^18F—FDGPET／CT的优势之一。

Objective To explore the clinical diagnostic value of ^18 F-FDG PET/CT in patients with kidney neoplasms. Methods Seventy-nine patients （ 52 males, 27 females, average age （ 57.3 ± 14.1 ） years） , who had definitive diagnosis of kidney neoplasms by ^18F-FDG PET/CT and pathological or clinical comprehensive diagnosis in recent five years, were analyzed retrospectively. The diagnosis by PET/CT was made according to the changes of kidney shape, tumor density and FDG uptake （ SUVmax ）. The diagnostic efficacy was calculated. Results Among the 79 patients, 70 cases were finally diagnosed as malignant tumors （ including 40 cases of renal cell carcinoma, 5 cases of renal pelvis carcinoma, 8 cases of lymphoma, 16 cases of metastatic tumor, and 1 case of renal fascia capsule liposarcoma） and 9 cases of benign tumors （ including 7 cases of angiomyolipomas, 1 case of renal acidophilic cell adenoma, 1 case of metanephrie adenoma; the benign tumors did not contain small lipid sample hamartoma cases ）. The detective rate of kidney neoplasms with 18F-FDG PET/CT was 97.5% （77/79）. For the identification of benign and malignant lesions, the sensitivity of ^18 F-FDG PET/CT was 92.9% （65/70）, specificity was 7/9, accuracy was 91.1% （72/79）, positive predictive value was 97.0% （65/67）, and negative predictive value was 58.3 % （7/12）. Condusions ^18 F-FDG PET/CT can detect and identify most of kidney tumors. Whole-body checking and comprehensive evaluation on kidney cancer patients are still the main advantages of PET/CT.