^(18)F-FDG PET/CT动态成像诊断原发性肝癌与肝转移瘤的价值

The value of ^(18)F-FDG PET/CT dynamic imaging in the diagnosis of primary hepatocellular carcinoma with liver metastases

目的探讨^(18)F-FDG PET/CT动态成像诊断原发性肝癌与肝转移瘤中的应用价值。方法该研究以通过全身动态^(18)F-FDG PET/CT成像的94例肝脏恶性病变[肝细胞癌组(25例)、胆管细胞癌组(27例)、肝转移瘤组(42例)]的患者资料作为研究对象,应用单因素方差分析(ANOVA)、受试者工作特征曲线(ROC)等方法对不同病理类型肝恶性肿瘤患者的:病灶最大标准化摄取值(SUV_(max))、FDG代谢率(MR_(FDG))、靶-本底比值(TBR)和病灶的最大直径(d_(max))等影像学特征进行统计学分析。结果在94例患者中,肝细胞癌组、胆管细胞癌组和肝转移瘤组的SUV_(max)、MR_(FDG)、TBR_(SUV_(max))和TBR_(MRFDG)差异均有统计学意义(SUV_(max):F=48.773,P<0.001;MR_(FDG):F=26.334,P<0.001;TBR_(SUV_(max)):F=41.314,P<0.001;TBR_(MRFDG):F=20.821,P<0.001)。SUV_(max)、MR_(FDG)、TBR_(SUV_(max))和TBR_(MRFDG)鉴别诊断原发性肝癌与肝转移瘤的AUC分别为0.836、0.851、0.827和0.847。SUV_(max)、MR_(FDG)与肝脏恶性肿瘤病灶的最大直径d_(max)之间存在正相关(SUV_(max):r=0.4,P<0.05;MR_(FDG):r=0.2,P<0.05),差异有统计学意义。结论^(18)F-FDG PET/CT动态成像在不同病理类型肝脏恶性肿瘤中有较好的鉴别诊断效能。不同病理类型肝脏恶性肿瘤SUV_(max)、MR_(FDG)和病灶的最大直径d_(max)之间存在一定正相关关系。

Objective To explore the value of ^(18)F-FDG PET/CT dynamic imaging in the diagnosis of primary liver cancer and liver metastases.Methods In this study,the data of 94 patients with hepatic malignant lesions[hepatocellular carcinoma group(25 cases),cholangiocellular carcinoma group(27 cases),and liver metastases group(42 cases)]imaged by whole-body dynamic ^(18)F-FDG PET/CT were used as the research subjects,and the methods of(ANOVA)and subjects′working characteristic curves(ROC)were applied to examine the patients with liver malignant tumours of different pathological types SUV_(max),MR_(FDG),TBR and d_(max) were statistically analysed as imaging features.Results Among 94 patients,the differences in SUV_(max),MR_(FDG),TBR SUV_(max) and TBR MRFDG were statistically significant in the hepatocellular carcinoma,cholangiocellular carcinoma and hepatic metastasis groups(SUV_(max):F=48.773,P<0.001;MR_(FDG):F=26.334,P<0.001;TBR_(SUV_(max)):F=41.314,P<0.001;TBR_(MRFDG):F=20.821,P<0.001).The AUCs for the differential diagnosis of primary hepatocellular carcinoma and hepatic metastases for SUV_(max),MR_(FDG),TBR_(SUV_(max)),and TBR MRFDG were 0.836,0.851,0.827,and 0.847,respectively.There was a positive correlation between SUV_(max),MR_(FDG),and the hepatic malignant lesions′There was a positive correlation between SUV_(max),MR_(FDG) and the maximum diameter d max(SUV_(max):r=0.4,P<0.05;MR_(FDG):r=0.2,P<0.05),and the difference was statistically significant.Conclusion ^(18)F-FDG PET/CT dynamic imaging has good differential diagnostic efficacy in different pathological types of liver malignant tumors.There is a positive correlation between SUV_(max),MR_(FDG) and d_(max) in different pathological types of liver malignant tumors.