^(18)氟-脱氧葡萄糖PET显像对鼻咽癌放射治疗后咽旁间隙复发的诊断价值

Clinical value of ^(18) F-fluoro-2-deoxy-D-glucose positron emission tomography in detecting recurrent nasopharyngeal carcinoma at the parapharyngeal space after radiotherapy

目的探讨18氟-脱氧葡萄糖正电子发射断层扫描仪(18FDG-PET)对鼻咽癌放射治疗后咽旁间隙复发或纤维化的临床诊断价值。方法32例行CT、MRI检查后不能确定鼻咽癌放射治疗后咽旁间隙是否复发或纤维化的患者,采用18FDG-PET显像,同时行CT、MRI检查。所有患者于CT、MRI及18FDG-PET检查后,在CT引导下穿刺活检,观察不同检查方法的灵敏度、特异度和诊断符合率。结果CT检查的灵敏度79.16%、特异度75.00%、诊断符合率78.13%;MRI检查的灵敏度83.33%、特异度87.50%、诊断符合率84.38%;18FDG-PET检查的灵敏度95.83%、特异度87.50%、诊断符合率93.75%。结论怀疑鼻咽癌放射治疗后咽旁间隙复发的患者可以考虑行18FDG PET检查,免除病理穿刺活检的风险;也可通过CT和/或MRI检查,采取CT引导下咽旁间隙穿刺活检达到确诊的目的。

Objective To explore the significance of 18 F-fluoro-2-deoxy-D-glucose positron emission tomography ( 18 FDG-PET) in the diagnosis of the recurrence or fibrosis of nasopharyngeal carcinoma at the parapharyngeal space after radiotherapy. Methods Thirty-two patients having received radiotherapy for nasopharyngeal carcinoma at the parapharyngeal space underwent 18 FDG-PET in parallel with CT and magnetic resonance imaging (MRI) examinations to detect the recurrence or fibrosis of the tumors after the treatment, when the latter two examinations had failed to yield definite results. After all the imaging examinations, CT-guided puncture biopsy was performed in each case to observe the sensitivity, specificity and accuracy of the examinations. Results The sensitivity, specificity and accuracy were 79.16%, 75.00%, and 78.13% respectively for CT examination, and were 83.33%, 87.50%, and 84.38% for MRI. 18 FDG-PET had the best sensitivity, specificity and accuracy in detecting tumor recurrence, which were 95.83%, 87.50%, and 93.75% respectively. Conclusion 18 FDG-PET can be considered in cases of suspected recurrence of nasopharyngeal carcinoma at the parapharyngeal space after radiotherapy, and CT and MRI examinations either used alone or in combination may also reach definite diagnosis with the help of CT-guided biopsy.