CT和PET/CT在恶性胸膜间皮瘤诊断中的应用
 |
| 第1页 |
参见附件(5345KB，5页)。
[摘要] 目的 分析恶性胸膜间皮瘤的CT影像特点，探讨CT和PET/CT在其诊断的作用。方法 回顾性分析22例经病理证实的恶性胸膜间皮瘤患者资料，所有患者均匀CT平扫和增强扫描，其中8例行PET/CT检查。 结果 22例患者均表现为不同程度单侧胸膜增厚，5例为结节状，17例为弥漫性不规则胸膜增厚。8例行PET/CT患者中，在原发灶PET/CT未提供更多信息，但2例发现纵隔淋巴结转移，1例发现远处转移。2例患者治疗方案发生变化。结论 CT能很好地显示胸膜病变的形态、范围；PET/CT在肿瘤的分期及治疗中起重要补充作用。
[关键词] 断层摄影术； X线计算机； 正电子发射型计算机断层扫描； 恶性胸膜间皮瘤
[中图分类号] R681.5 [文献标识码] A [文章编号] 1005-0515(2011)-05-021-02
Application of CT and PET/CT in Diagnosis of M alignant Pleural Mesothelioma
Xie Hongbo1 Yang Youyou1 Wang Shiyun2
(1 Department of Radiology, The First Affiliated Hospital, SUN Yat-sen University;
2 Nuclear Medicine Department//Weilun PET Center, Guangdong General Hospital, Guangzhou，510080, China)
[Abstract] Objective To study the CT features of the m alignant pleural mesothelioma, and discuss the value of CT and PET/CT in the diagnosis and therapy. Methods Retrospectively analyze the 22 patients confirmed by histology. Native and contrast scan were performed on all patients. 8 of them were with PET/CT. Results All the cases demonstrated various lateral pleural thickening. There were nodular pleural thickening (n=5), diffuse pleural thickening (n=17). PET/CT did not provide additional information about the primary tumor, but identified a higher number of metastatic mediastinal lymph nodes in 2 patients and metastatic disease to distant sites in 1 patient. 2 patients treatment planning were changed on the basis of PET/CT findings. Conclusion CT display the location and shape well of pleural lesion; PET/CT is better in staging of the tumor and guiding the therapy.
[Keywords] computed tomography, X-ray; positron emission tomography; m alignant pleural mesothelioma
虽然恶性胸膜间皮瘤(m alignant pleural mesothelioma, MPM)是一种少见肿瘤，但恶性程度极高。恶性胸膜间皮瘤起源于胸膜间皮细胞，病情发展较快，若不治疗，生存期约4-12个月。而且近年来发病率呈上升趋势。病变早期外科根治术效果良好，病变后期则需要放疗、化疗、手术和免疫综合治疗。所以肿瘤的准确分期在治疗方案拟定中起重要作用[1]。本研究收集22例恶性胸膜间皮瘤患者资料，分析CT和PET/CT的诊断价值。
1 资料和方法
1.1 临床资料 收集2000年1月至2008年12月经病理证实恶性胸膜间皮瘤患者22例。男15例，女7例，年龄33-79岁，平均年龄58岁，3例患者有石棉接触史。所有患者均行CT平扫和增强扫描，其中8例行PET/CT检查。患者就诊原因包括呼吸困难、胸痛、发热、咳嗽等。所以病例均经病理证实，手术13例，胸腔镜活检6例，CT引导下穿刺活检3例。
1.2 影像学检查 CT扫描：管电压120KV，管电流120mAs，层厚5mm，层间隔5mm，必要时重建薄层图像。扫描范围为胸部。检查前行呼吸训练，确保患者屏气良好，吸气末进行扫描。
PET/CT扫描：所有检查者空腹6小时以上，测空腹血糖，在正常范围者注射药物18F-FDG(荧光脱氧葡萄糖) ......
您现在查看是摘要介绍页，详见PDF附件(5345KB，5页)。