^(18)F-FDG PET检查在结直肠癌诊断和术后随访中的意义

Significance of ^(18) F-FDG PET examination on diagnosis and postoperative follow-up of colorectal cancer

目的 :评价 1 8F-脱氧葡萄糖 (1 8F- FDG)正电子发射型体层摄影 (PET)在结直肠癌诊断和术后随访中的作用和意义。方法 :结肠癌 6例、直肠癌 3例术前行 PET检查 ;结肠癌 10例、直肠癌 12例术后行 PET检查。 结果 :(1) 9例结直肠癌术前PET检查有 8例发现结直肠部位 2 .8cm× 3.0 cm～ 4 .1cm× 5 .0 cm大小高代谢浓聚影 ,其中有 5例合并肝脏、骨骼、盆腔淋巴结等脏器转移 ;另 1例结肠镜检查发现横结肠肝曲部位有 1.1cm× 1.2 cm溃疡 ,病理活检示结肠癌 ,但 PET检查未能发现 ;(2 ) 10例结肠癌术后不同时期行 PET检查 ,有 6例显示肝、肾上腺及腹壁转移 ,1例显示吻合口复发 ;12例直肠癌术后PET检查发现有 5例肝、肺、纵隔及腹腔淋巴结等器官转移 ,1例显示乙状结肠 -直肠吻合口复发。 结论 :1 8F- FDG PET检查对结直肠癌诊断和术后随访灵敏度、准确性均高 。

Objective:To evaluate the effects of 18 F FDG PET examination on diagnosis and postoperative follow up in colorectal cancer.Methods:six preoperative colonic cancer patients, 3 preoperative rectal cancer patients received PET,10 postoperative colonic cancer patients and 12 postoperative rectal cancer patients received PET (23 males,8 females; 38 80 years old).Results:In 9 cases of colorectal cancers with preoperative PET imaging,8 showed 2.8 cm×3.0 cm to 4.1 cm× 5.0 cm high concentrative uptake imagings and 5 showed the metastases such as liver,bone and pelvic lymphaden.One case didnot show abnormal imaging though 1.1 cm×1.2 cm ulcerative cancer on transverse colon was diagnosed by colo endoscopy and pathology; 6 cases of liver,adrenal and abdominal metastases and 1 case of sigmoid rectal anastomotic recurrence were detected in 10 postoperative patients of colonic cancers at the different stages of PET imaging.In 12 postoperative patients with rectal cancers,5 cases with liver,lung,mediastinal and abdominal lymphaden metastases were found.Sigmoid rectal anastomotic recurrence was detected in 1 case.Conclusion: 18 F FDG PET appears to be a valuable method for the assessing diagnosis and postoperative follow up of colorectal cancer.