18F-FDG PET/CT显像对非结节型肝外胆管腺癌的诊断价值

Diagnostic Value of 18F-FDG PET/CT Imaging in Non-Mass-Forming Extrahepatic Cholangioadenocarcinoma

目的探讨18F-FDG PET/CT显像在非结节型肝外胆管腺癌诊断中的价值。资料与方法回顾性分析122例怀疑非结节型肝外胆管腺癌,并行18F-FDG PET/CT检查的患者。根据病理结果将患者分成高分化腺癌组、中分化腺癌组、低分化腺癌组和良性病变组。比较各组最大标准化摄取值(SUVmax)的差异,并通过受试者工作特征曲线分析其诊断病变良恶性的最佳临界点;分析病灶SUVmax与肿瘤分化程度的相关性;比较不同分组患者双时相18F-FDG PET/CT显像SUVmax的滞留指数(RIsuv)的差异。结果非结节型肝外胆管腺癌的分化程度与其SUVmax呈负相关(r=-0.454,P=0.000);SUVmax诊断病变良恶性的最佳临界点为3.8,对应诊断敏感度与特异度分别为57.58%和86.36%。中、低分化腺癌组SUVmax均显著高于良性病变组,差异有统计学意义(P<0.05);而高分化腺癌组与良性病变组患者SUVmax差异无统计学意义(P=0.822);双时相显像RIsuv差异无统计学意义(Z=-1.063,P=0.288)。结论18F-FDG PET/CT显像对诊断中、低分化非结节型肝外胆管腺癌具有重要价值,但对高分化非结节型肝外胆管腺癌的诊断价值有限。

Purpose To explore the value of 18F-FDG PET/CT imaging in the diagnosis of non-mass-forming extrahepatic cholangiocarcinoma.Materials and Methods 122 patients with suspected non-mass-forming extrahepatic bile duct adenocarcinoma who underwent 18F-FDG PET/CT examination were retrospectively analyzed.According to the pathological results,all patients were divided into highly,moderately,poorly differentiated cholangioadenocarcinoma and benign diseases group.The SUVmax among the groups were compared,and the optimal SUVmax cutoff values in the differential diagnosis of non-mass-forming extrahepatic cholangioadenocarcinoma and benign diseases were analyzed with ROC curve.The correlation between SUVmax and the differentiated degree of cholangioadenocarcinoma was analyzed.The retention index of SUVmax(RIsuv)of dual-phase 18F-FDG PET/CT among the groups were compared.Results The differentiated degree of extrahepatic cholangioadenocarcinoma was negatively correlated with its SUVmax(r=-0.454,P=0.000).The best SUVmax cutoff was 3.8,the sensitivity and specificity for the differentiation of malignant from benign disease were 57.58%and 86.36%,respectively.The SUVmax of moderately and poorly differentiated tumors were higher than that of benign disease(P<0.05).But there was no significant differences in SUVmax between highly differentiated tumors and benign disease(P=0.822),neither in the RIsuv detected on dual-phase 18F-FDG PET/CT(Z=-1.063,P=0.288).Conclusion 18F-FDG PET/CT is a useful tool in the diagnosis of moderately and poorly differentiated non-mass-forming extrahepatic cholangioadenocarcinoma,but the value of 18F-FDG PET/CT in the differentiation of highly differentiated tumors from benign lesions is limited.