^(18)F-FDG PET/CT在胰腺良恶性病变的诊断及鉴别诊断中的价值

Application of ^(18)F-FDG PET/CT in the Diagnosis and Differential Diagnosis of Benign and Malignant Pancreatic Lesions

目的探讨18F.FDG PET/CT在诊断胰腺良恶性病变的诊断及鉴别诊断中的价值。方法共112例胰腺病变患者行PET/CT检查,后经手术切除、穿刺活检、ERCP等手段取得细胞组织病理学结果或经临床诊断及临床随访,最终综合诊断胰腺恶性病变共74例,胰腺良性病变38例,分析PET/CT的影像表现特点。结果胰腺良恶性病变早期SUVmax值的差异有统计学意义(P<0.05);胰腺良性病变早期与延迟SUVmax值的差异无统计学意义(P>0.05);胰腺恶性病变早期与延迟SUVmax值的差异有统计学意义(P<0.05);胰腺良恶性病变FDG摄取的轮廓、形态、分布、位置的差异有统计学意义(P<0.05);胰腺病变肿块大小和早期SUVmax值存在一定的线性相关;PET/CT对胰腺肿块不同大小诊断的差异有统计学意义(P<0.05);PET/CT对胰腺病变诊断的敏感度、特异性、阳性预测值、阴性预测值和准确性分别为89.2%、63.2%、82.5%、75.0%和80.4%。结论PET/CT在胰腺良恶性病变的诊断及鉴别诊断中有较好的应用价值。

Objective To investigate the value of ^18F-FDG PET/CT in the diagnosis and differential diagnosis of pancreatic benign and malignant lesions. Methods A total of 112 patients with pancreatic lesions were enrolled for the study. These patients underwent PET/CT, surgery, biopsy, ER- CP, and other therapeutic means. The final comprehensive diagnosis was obtained by clinical diagnostic pathology results and clinical long-term clinical follow-up ： 74 cases of pancreatic malignancy and 38 eases of the benign pancreatic lesions. Results The difference of early SUVmax values between pancreatic benign and malignant lesions was statistically significant （P 〈 0.05）. The difference between early and delayed SUVmax values of pancreatic benign lesions was not significant （ P 〉 0.05 ）. The difference between early and delayed SUVmax values of pancreatic malignant lesions was statistically significant （P 〈 0.05 ）. The differences of FDG accumulation pattern of contour, shape, distribution and location between benign and malignant pancreatic lesions were statistically significant （P 〈 0.05 ）. There was a partial linear correlation between early SUVmax values and pancreatic tumor sizes ; The differences of PET/CT for the diagnosis among three different pancreatic sizes were statistically significant （P 〈 0.05 ） ; The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of PET/CT diagnosis in benign and malignant pancreatic lesions were 89.2%, 63.2 %, 82.5%, 75.0%, and 80.4%, repeetively. Conclusion PET/CT has good application value in the diagnosis and differential diagnosis of the benign and malignant pancreatic lesions.