18F-FDG PET/CT发现皮下结节的临床价值

The Clinical Value of 18F-FDG PET/CT in Finding Subcutaneous Nodules

目的回顾性分析全身18F-FDG PET/CT显像病例意外发现皮下结节异常图像探讨PET/CT发现皮下结节的临床应用价值。方法分析近十年12000个病例,意外发现皮下结节18F-FDG显像阳性病例143例。以结节SUVmax>2.5且组织密度增高为阳性结果,排除淋巴瘤病例。115例阳性病例行病理穿刺或活检。结果 115例经病理证实患者中,19例良性,96例恶性。96例恶性肿瘤中,38例为术后病例,36例为手术前22例原发病灶不明。共发现皮下病灶164处,单一病灶患者59例,两个病灶22例,三个及以上病灶15例。15例病灶位于手术切口附近主要为结直肠癌病例;4例位于穿刺引流途径;22例原发灶不明患者,以皮下结节为主诉症状,PET/CT协助定性定位11例。结论全身PET/CT显像发现表浅部位阳性病灶肿瘤诊断明确者可帮助分期,有助于寻找原发灶,并予穿刺定位。鉴于手术切口及穿刺途径容易发生种植转移建议临床医生在操作时,重视对切口的保护。

Objective To explore the clinical value of PET/CT in finding subcutaneous nodules,through retrospective analysis of systemic 18 f-fdg PET/CT imaging cases in which abnormal images of subcutaneous nodules were accidentally found.Methods 12,000 cases in the last ten years were analyzed showed that 143 cases were positive for 18 F-FDG imaging.Nodular SUVmax>2.5 and increased tissue density were positive results,and lymphoma cases were excluded.Pathological puncture or biopsy was performed in 115 positive cases.Results All 115 patients were confirmed by pathology,19 were benign and 96 were malignant.In 96 malignant tumors cases,38 cases were postoperative,36 cases were preoperative 22 cases were unknown.There were 164 subcutaneous lesions,59 cases with single lesion 22 cases with two lesions and 15 cases with three or more lesions.15 cases were located near the incision plainly colorectal cancer,4 cases were located in the way of puncture and drainage,22 cases with unknown primary focus who the main symptom was subcutaneous nodule,11 cases were located qualitatively with the help ofPET/CT.Conclusion The superficial positive lesions would be found by whole body PET/CT imaging which could help to definite stage for definitely diagnosed tumor patients andfind the primary focus which could make puncture location.In view of the fact that surgical incision and puncture route are prone to implant transfer,it is suggested that clinicians should pay more attention to the protection of the incision during the operation.