水灌肠^18F—FDGPET／CT在直肠癌诊断中的应用价值

Value of water enema ^18F-FDG PET/CT for diagnosis of rectal cancer

目的探讨水灌肠^18F-FDGPET／CT检查在直肠癌诊断中的应用价值。方法回顾性分析69例[男52例，女17例；平均年龄57．9岁]临床怀疑为直肠癌患者的常规及水灌肠^18F-FDGPET／CT资料，与肠镜或术后病理结果进行对照，比较2种方法对直肠癌的诊断效能，同时比较不同病灶SUVmax的差异。采用配对t检验及McNemar检验对数据进行统计学分析。结果病理证实直肠癌61例，非直肠癌8例。61例直肠癌患者灌肠前后SUVmax差异有统计学意义（13．17±6．19与14．25±6．63；t=-6．100，P〈0．01）。常规PET／CT诊断直肠癌的灵敏度为90．2％（55／61），特异性为4／8，准确性为85．6％（59／69）；水灌肠PET／CT相应指标为98．4％（60／61），6／8，95．7％（66／69），2种方法诊断直肠癌的准确性差异有统计学意义（x^2=5．140，P〈0．05）。结论水灌肠PET／CT弥补了常规PET／CT的不足，提高了对直肠癌诊断的准确性。

Objective To investigate the diagnostic value of delayed water enema ^18F-FDG PET/ CT for rectal cancer. Methods Sixty-nine cases （52 males, 17 females; average age 57.9 years） with clinically suspected rectal cancer underwent routine and delayed water enema ^18F-FDG PET/CT. The imaging results were compared with colonoseopy and surgical pathology. The diagnostic efficiency of the two imaing methods was compared and so was the SUVmax of lesions. Paired t and McNemar test were used to analyze the data. Results There were 61 rectal cancer cases confirmed by pathology. The SUVmax of rectal cancer calculated from routine and delayed water enema ^18F-FDG PET/CT was significantly different （ 13. 17±6.19 vs 14.25±6.63; t=-6.100, P〈0.01 ）. The sensitivity, specificity and accuracy of routine ^18F-FDG PET/CT and delayed water enema ISF-FDG PET/CT in diagnosis rectal cancer were 90.2% （55/61） vs 98.4% （ 60/61 ）, 4/8 vs 6/8, 85.6% （59/69） vs 95.7% （66/69）. A statistically significant difference was found in diagnostic accuracy between the two imaging methods （x^2= 5.140, P〈0.05）. Conclusion The delayed water enema ^18F-FDG PET/CT has a complementary diagnostic value for routine ^18F-FDG PET/CT in rectal cancer.