[1]罗家伦,徐慧琴,何延辉,等.18F-FDG PET-CT在肾上腺转移癌诊断中的价值及其诊断标准探讨[J].国际放射医学核医学杂志,2012,36(2):87-91.[doi:10.3760/cma.j.issn.1673-4114.2012.02.007]
　LUO Jia-lun,XU Hui-qin,HE Yan-hui,et al.Diagnostic value and diagnostic criteria of 18F-FDG PET-CT in adrenal metastasis[J].International Journal of Radiation Medicine and Nuclear Medicine,2012,36(2):87-91.[doi:10.3760/cma.j.issn.1673-4114.2012.02.007]
点击复制

18F-FDG PET-CT在肾上腺转移癌诊断中的价值及其诊断标准探讨(/HTML)
分享到：

《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
36
期数:
2012年第2期
页码:
87-91
栏目:
临床核医学
出版日期:
2012-03-25

文章信息/Info

Title:
Diagnostic value and diagnostic criteria of 18F-FDG PET-CT in adrenal metastasis
作者:
罗家伦;  徐慧琴;  何延辉;  薛央扬;  赵学峰;  岳峤
安徽医科大学第一附属医院核医学科, 合肥 230022
Author(s):
LUO Jia-lun;  XU Hui-qin;  HE Yan-hui;  XUE Yang-yang;  ZHAO Xue-feng;  YUE Qiao
Department of Nuclear Medicine, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
关键词:
肾上腺肿瘤; 肿瘤转移; 正电子发射断层显像术; 体层摄影术; X线计算机; 氟脱氧葡萄糖F18
Keywords:
Adrenal gland neoplasms; Neoplasm metastasis; Positron-emission tomography; Tomography;  X-ray computed; Fluorodeoxyglucose F18
DOI:
10.3760/cma.j.issn.1673-4114.2012.02.007
摘要:
目的 研究18F-FDG PET-CT对肾上腺转移性癌的诊断价值,并探讨其最佳诊断标准.方法 对59例术后病理或临床随访确诊为肾上腺转移癌及18例肾上腺良性病变患者行18F-FDGPET-CT检查,分别测量肾上腺病灶的大小、SUVmax及正常肝组织的SUVmax,进行综合分析.结果 59例肾上腺转移癌患者共78个肾上腺病灶,SUVmax为7.05±5.26,18例良性病变患者共21个肾上腺病灶,SUVmax为2.27±1.35,两者之间的差异有统计学意义(t=7.199,P<0.01);肾上腺转移癌与良性病灶的大小(短径)分别为(1.52±1.05)cm和(1.66±0.91) cm,两者之间的差异无统计学意义(t=0.529,P>0.05).受试者工作特征曲线分析,以肾上腺病灶SUVmax>3.1作为良恶性的诊断标准,其诊断灵敏度、特异度和准确率分别为83.3%、90.5%和84.9%;以肾上腺病灶SUVmax与正常肝组织的SUVmax比值>1作为良恶性诊断标准,则诊断的灵敏度、特异度、准确率分别为96.2%、90.5%和95.0%;肾上腺转移癌病灶大小(短径)与其SUVmax相关系数为0.501.肾上腺转移癌在双侧肾上腺的分布比例为:左侧30例(50.8%),右侧10例(17.0%),双侧19例(32.2%).结论 18FFDG PET-CT对于肾上腺转移瘤的诊断具有较高的灵敏度及准确率;以肾上腺病灶SUVmax与正常肝组织的SUVmax比值>1为标准,可较好地诊断出肾上腺转移瘤的良恶性;肾上腺转移癌病灶的大小与其SUVmax有一定相关性,病灶常累及左侧。
Abstract:
Objective To investigate the value of 18F-FDG PET-CT in the diagnosis of the adrenal metastasis and study its diagnostic criteria.Methods Fifty-nine patients with adrenal metastasis and 18 patients with adrenal benign tumor underwent 18F-FDG PET-CT,all of the adrenal lesion’s diameter and FDG maximum standardized uptake values (SUVmax),SUVmax of normal liver were measured and analyzed comprehensively.All lesions underwent biopsy after operation or follow-up in clinic or imaging diagnosis for final diagnosis.Results There were 78 adrenal lesions of 59 cases with adrenal metastasis,and 21 adrenal lesions of 18 cases with adrenal benign.The SUVmax of adrenals metastasis was 7.05 ±5.26,while benign tumor was 2.27±1.35,statistical significant difference was found between the 2 groups (t=7.199,P<0.01).The short diameter of adrenal metastasis was (1.66±0.91) cm,benign tumor was (1.52±1.05) cm,there was no statistical significant difference between the 2 groups (t=0.529,P>0.05).Receiver operator characteristic curve analysis showed that using lesion’s SUVmax >3.1 as the diagnostic criteria of benign and metastatic adrenal lesions,the sensitivity,specificity and accuracy of 18F-FDG PET-CT in diagnosis of adrenals metastasis were 83.3%,90.5% and 84.9%,respectively.But if using the SUVmax of adrenal lesion exceeds normal liver tissue as the diagnostic criteria,the sensitivity,specificity and accuracy were 96.2%,90.5% and 95.0%.For adrenals metastasis,the correlation coefficient between lesion size (short diameter) and SUVmax was 0.501.Among all 59 cases with adrenal metastasis,30(50.8%) patients’ lesions in the left adrenal gland,10(16.9%) in the right side and 19 (32.2%) in the both sides.Conclusion 18F-FDG PET-CT has high sensitivity andaccurate in diagnosis of adrenal metastasis,and the SUVmax of adrenal lesion exceeds normal liver tissue is a better diagnostic criteria.The size of adrenal metastasis lesions has certain correlation with its SUVmax and the lesions often in the left side gland and lung cancer is the more common primary tumor.

参考文献/References:

[1] Metser U, Miller E, Lerman H, et al. 18F-FDG PET/CT in the evaluation of adrenal masses. J Nucl Med, 2006, 47(1):32-37.
[2] Haider MA, Ghai S, Jhaveri K, et al. Chemical shift MR imaging of hyperattenuating (>10 HU) adrenal masses:does it still have a role?. Radiology, 2004, 231(3):711-716.
[3] 潘中允,曲婉莹, 周诚,等.PET/CT诊断学.北京:人民卫生出版社,2009:702.
[4] Katz R1, Shirkhoda A. Diagnostic approach to incidental adrenal nodules in the cancer patient. Results of a clinical, radiologic, and fine-needle aspiration study. Cancer, 1985, 55(9):1995-2000.
[5] Boland GW, Goldberg MA, Lee MJ, et al. Indeterminate adrenal mass in patients with cancer:evaluation at PET with 2-[F-18]-fluoro-2-deoxy-D-glucose. Radiology, 1995, 194(1):131-134.
[6] Jana S, Zhang T, Milstein DM, et al. FDG-PET and CT characterization of adrenal lesions in cancer patients. Eur J Nucl Med Mol Imaging, 2006, 33(1):29-35.
[7] Blake MA, Slattery JM, Kalra MK, et al. Adrenal lesions:characterization with fused PET/CT image in patients with proved or suspected malignancy-initial experience. Radiology, 2006, 238(3):970-977.
[8] 张占文,胡平,王晓燕,等.肾上腺转移瘤18F-FDG PET/CT的影像特征及诊断价值.重庆医学,2011,40(8):774-775.
[9] Lu Y, Xie D, Huang W, et al. 18F-FDG PET/CT in the evaluation of adrenal masses in lung cancer patients. Neoplasma, 2010, 57(2):129-134.
[10] Anderson SB, Webb MD, Banks KP. Adrenal collision tumor diagnosed by F-18 fluorodeoxyglueose PET/CT. Clin Nuel Med, 2010, 35(6):414-417.
[11] Klingenstein A,Haug AR,Nentwich MM,et al.Whole-body F-18-fluoro-2-deoxyglucose positron emission tomography/computed tomography imaging in the follow-up of metastatic uveal melanoma.Melanoma Res,2010,20(6):511-516.
[12] 田嘉禾.PET、PET/CT诊断学.北京:化学工业出版社,2007:123.
[13] Sohn MH,Jeong HJ,Lim ST,et al.F-18 FDG uptake in an eosinophilic liver abscess mimicking hepatic metastasis on PET/CT images.Nucl Med Mol Imaging,2008,42(3):253-255.
[14] Demir H,Halac M,Yilmaz S,et al.A doughnut sign of a hydatid cyst of the liver on F-18 FDG PET/CT.Clin Nucl Med,2008,33(12):876-877.

相似文献/References:

[1]廖光星,冷志欣,肖国有.前列腺癌骨转移影像诊断方法研究进展[J].国际放射医学核医学杂志,2016,40(6):464.[doi:10.3760/cma.j.issn.1673-4114.2016.06.012]
　Liao Guangxing,Leng Zhixin,Xiao Guoyou.Progress of imaging in the diagnosis of bone metastases of prostate cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2016,40(2):464.[doi:10.3760/cma.j.issn.1673-4114.2016.06.012]
[2]张胤,陈跃.18F-氟化钠PET/CT诊断肿瘤骨转移应用进展[J].国际放射医学核医学杂志,2015,39(1):96.[doi:10.3760/cma.j.issn.1673-4114.2015.01.020]
　Zhang Yin,Chen Yue.Application progress of 18F-NaF PET/CT in the diagnosis of neoplasm metastases[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(2):96.[doi:10.3760/cma.j.issn.1673-4114.2015.01.020]
[3]徐金苹,袁德晓,张江虹,等.辐射诱导的外泌体在肿瘤细胞侵袭转移中的作用[J].国际放射医学核医学杂志,2015,39(2):144.[doi:10.3760/cma.j.issn.1673-4114.2015.02.009]
　Xu Jinping,Yuan Dexiao,Zhang Jianghong,et al.The role of radiation-induced exosomes in tumor invasion and metastasis[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(2):144.[doi:10.3760/cma.j.issn.1673-4114.2015.02.009]
[4]刘雪辉,李洪均,于鸿煦.SPECT/CT融合显像对可疑骨转移灶的诊断效能[J].国际放射医学核医学杂志,2015,39(3):201.[doi:10.3760/cma.j.issn.1673-4114.2015.03.003]
　Liu Xuehui,Li Hongjun,Yu Hongxu.Diagnostic efficacy of SPECT/CT fusion imaging in assessing possible bone metastases[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(2):201.[doi:10.3760/cma.j.issn.1673-4114.2015.03.003]
[5]桂继琮,刘兴党.镭-223氯化物治疗去势抵抗性前列腺癌骨转移的研究进展[J].国际放射医学核医学杂志,2015,39(3):268.[doi:10.3760/cma.j.issn.1673-4114.2015.03.018]
　Gui Jicong,Liu Xingdang.Development in the study of radium-223 chloride for treating castration-resistant prostate carcinoma with bone metastases[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(2):268.[doi:10.3760/cma.j.issn.1673-4114.2015.03.018]
[6]高平,王茜,赵赟赟,等.99Tcm-MDP SPECT/CT显像用于骨肉瘤肺转移的诊断[J].国际放射医学核医学杂志,2014,38(3):148.[doi:10.3760/cma.j.issn.1673-4114.2014.03.002]
　Gao Ping,Wang Qian,Zhao Yunyun,et al.99Tcm-MDP SPECT/CT used in diagnosis of pulmonary metastasis from osteosarcoma[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(2):148.[doi:10.3760/cma.j.issn.1673-4114.2014.03.002]
[7]凌彩霞,肖国有.SPECT/CT骨断层显像及在恶性肿瘤骨转移诊断中的临床价值[J].国际放射医学核医学杂志,2014,38(4):275.[doi:10.3760/cma.j.issn.1673-4114.2014.04.016]
　Ling Caixia,Xiao Guoyou.The clinical value of SPECT/CT bone tomography in the diagnosis of malignant tumor metastasis[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(2):275.[doi:10.3760/cma.j.issn.1673-4114.2014.04.016]
[8]刘超,邓智勇,刘鹏杰,等.89SrCL2与唑来膦酸联合治疗乳腺癌转移性骨肿瘤的疗效分析[J].国际放射医学核医学杂志,2014,38(5):300.[doi:10.3760/cma.j.issn.1673-4114.2014.05.006]
　Liu Chao,Deng Zhi-yong,Liu Peng-jie,et al.Analysis on the curative effect of combination therapy with zoledronic acid and 89SrCL2 on bone tumor with breast cancer metastasis[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(2):300.[doi:10.3760/cma.j.issn.1673-4114.2014.05.006]
[9]王宇峰,刘海娜,张居洋,等.SPECT/CT融合显像对乳腺癌骨转移的诊断价值[J].国际放射医学核医学杂志,2014,38(6):387.[doi:10.3760/cma.j.issn.1673-4114.2014.06.010]
　Wang Yu-feng,Liu Hai-na,Zhang Ju-yang,et al.Clinical value of SPECT/CT fusion imaging in diagnosing metastatic bone lesions in breast cancer[J].International Journal of Radiation Medicine and Nuclear Medicine,2014,38(2):387.[doi:10.3760/cma.j.issn.1673-4114.2014.06.010]
[10]赵红光,徐松柏,关锋,等.骶骨脊索瘤伴肺转移18F-FDG PET/CT显像一例[J].国际放射医学核医学杂志,2013,37(2):128.[doi:10.3760/cma.j.issn.1673-4114.2013.02.017]

备注/Memo

备注/Memo:
收稿日期:2011-11-30。
基金项目:安徽省科技计划项目(10021303025)
通讯作者:徐慧琴,Email:hfxuhuiqin@163.com
更新日期/Last Update: 1900-01-01