^(18)F-FDG PET/CT在乳腺浸润性导管癌术前诊断及分期中的应用价值

The value of ^(18)F-FDG PET/CT in preoperative diagnosis and staging of invasive ductal carcinoma of breast

目的探讨乳腺浸润性导管癌的^(18)F-FDG PET/CT显像特点。方法回顾性分析13例经穿刺或手术病理证实的乳腺浸润性导管癌的术前^(18)F-FDG PET/CT图像特点,分析其病变SUVmax、密度、皮肤厚度、钙化有/无、同侧腋窝淋巴结、远处转移情况。结果 13例乳腺癌中,全部为浸润性导管癌,其中左侧乳腺癌2例,右侧乳腺癌8例,中央区乳腺癌3例。合并沙粒样钙化3例(23.1%),皮肤增厚7例(53.8%),同侧腋窝淋巴结增大8例(61.5%),手术病理证实为转移瘤,密度增高9例(69.2%),发生肝脏多发转移瘤及胸11椎体转移瘤1例,腰4、5椎体转移瘤1例,右侧颈部及锁骨上淋巴结、全身多发骨骼转移瘤1例,左锁骨上、纵隔淋巴结及全身多发骨骼转移瘤1例。所有病变SUVmax最大值10.7,SUVmax最小值1.8,平均SUVmax3.68±2.4,经统计学分析,健侧乳腺与患侧乳腺SUVmax差异有统计学意义。结论当乳腺密度局限或弥漫性增高伴局部皮肤增厚,同机PET上呈现轻～中度取增高,要考虑到乳腺浸润性导管癌的可能。此外,^(18)F-FDGPET显像在乳腺癌分期中也可以起到很好的参考价值。

Objective To study the imaging characteristics of invasive ductal carcinoma of the breast on 18 F-FDG PET/CT, in order to increase the understanding of the disease, and to improve the accuracy of diagnosis. Methods 13 cases of infiltrating ductal carcinoma confirmed by biopsy or surgical pathology and its preoperative 18 F-FDG PET/CT image of characteristics, including lesions's SUVmax, skin thickness, lesions's density, calcification, ipsilateral axillary lymph node and distant metastasis, were retrospectively analyzed. Results Of the 13 breast cancers, 2 cases located in the left breast, 8 cases in the right breast, and 3 cases in central area. Sand-like calcification was found in 3 cases (23.1%), skin thickening in 7 cases (53.8%), and ipsilateral axillary lymph node enlargement in 8 cases (61.5%), increased density in 9 cases (69.82%), 11th thoracic vertebral metastase and multiple metastases in liver in 1 case, lumbar 4, 5 vertebral metastatic tumor in 1 case, the right neck, supraclavicular lymph nodes, and multiple bone metastases in 1 case;multiple bone metastases and left supraclavicular and mediastinal lymph nodes in 1 case. The maximun of SUVmax of all lesions was 10.7, the minimum of SUVmax was 1.8, and the average SUVmax was 3.68±2.4, and according to statistically analyzing, significant difference was found between the healthy control breast and breast cancer. Conclusion When breast density localized or diffuse increased with local skin thickening, mild to moderate 18 F-FDG uptake on the PET image at the same time, the possibility of breast invasive ductal carcinoma should be taken into consideration, otherwise. 18 F-FDG PET imaging had very good reference value in the staging of breast cancer.