腹膜弥漫性病变的18F-FDG PET/CT特征

18F-FDG PET/CT Features of Diffuse Peritoneal Lesions

目的分析腹膜弥漫性病变的代谢值和代谢形态特点,以提高18F-FDG PET/CT诊断腹膜病变的影像学价值。资料与方法回顾性分析诊断明确的腹膜弥漫性病变98例,其中恶性组70例(包括转移癌亚组51例、原发病变亚组19例),良性组28例(包括炎性病变亚组20例、结核性病变亚组8例)。将腹膜形态分为弥漫性、散在结节状及无改变。测量各组及亚组腹膜病变18F-FDG摄取最大标准化摄取值(SUVmax),记录腹膜CT及PET形态信息。结果腹膜恶性组SUVmax值明显高于良性组,差异有统计学意义(6.59±3.26比4.31±1.90;t=3.403,P=0.001)。腹膜炎性病变亚组SUVmax值明显低于原发病变亚组及转移癌亚组(分别为3.75±1.50、6.32±2.66、6.68±3.47,P<0.05)。良、恶性病变的盆底腹膜PET形态构成比具有明显的区别(χ2=29.29,P<0.001)。与良性组相比,恶性组盆底腹膜PET形态中散在结节状改变的发生率为77.1%(54/70),高于弥漫性的2.9%(2/70)或无改变的20.0%(14/70)(χ2=25.1、11.34,P<0.01)。恶性组中,盆底腹膜在PET及PET/CT上出现散在结节状改变分别为77.1%(54/70)、80.0%(56/70),高于CT的45.7%(32/70),差异有统计学意义(χ2=14.59、17.62,P<0.001)。结论分析腹膜病变的18F-FDG代谢值及盆底腹膜的代谢形态有助于良、恶性腹膜弥漫性病变的鉴别。

Purpose To analyze the metabolic value and morphological characteristics of diffuse peritoneal lesions,so as to improve the imaging value of 18F-FDG PET/CT in the diagnosis of peritoneal lesions.Materials and Methods Ninety-eight patients with diffuse peritoneal lesions were retrospectively analyzed,including 70 cases in the malignant group(51 cases in the metastatic subgroup,19 cases in the primary subgroup)and 28 cases in the benign group(20 cases in the inflammatory subgroup and 8 cases in the tuberculous subgroup).The peritoneal morphology was divided into diffuse,scattered nodular and unchanged.The maximum standardized uptake value(SUVmax)of 18F-FDG for peritoneal lesions in each group and subgroup was measured,and the morphological information of peritoneal CT and PET were also recorded.Results The SUVmax in the peritoneal malignant group was approximately,which was significantly higher than that in the benign group,the difference was statistically significant(6.59±3.26 vs.4.31±1.90;t=3.403,P=0.001).The SUVmax value of the peritonitis subgroup was significantly lower than that of the primary subgroup and the metastatic subgroup,with statistically significant difference(3.75±1.50,6.32±2.66,6.68±3.47,respectively;P<0.05).The morphological composition ratio of pelvic peritoneum PET for benign and malignant lesions was significantly different(χ2=29.29,P<0.001).Compared with the benign group,the incidence of scattered nodules in pelvic peritoneal PET morphology was 77.1%(54/70)higher than that of diffuse 2.9%(2/70)or unchanged 20.0%(14/70)(χ2=25.1 and 11.34,P<0.01)in the malignant group.In the malignant group,77.1%(54/70)and 80.0%(56/70)of scattered nodular changes in PET and PET/CT pelvic peritoneum were higher than that of CT 45.7%(32/70),the difference was statistically significant(χ2=14.59 and 17.62,P<0.001).Conclusion Analyzing the 18F-FDG metabolic value of peritoneal lesions and the metabolic morphology of the pelvic peritoneum are helpful for the differentiation of benign and malignant diffuse peritoneal lesions.