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目的:探讨11C-胆碱PET/CT显像在PSA升高的前列腺良恶性病变中鉴别诊断及术前分期的应用价值。方法:PSA升高的前列腺病变患者40例,静脉注射0.2mli/kg11C-胆碱5min后行仰卧位盆腔PET/CT显像,必要时加做全身显像。测量病变组织与对照组织的最高SUV(SUVmax),并计算其比值(P/M),通过半定量法分析显像结果。结果:病理证实前列腺增生及炎症共17例,前列腺癌23例。前列腺良恶性病变的P/M值之间的差异具有显著性。以P/M>2.14为标准,11C-胆碱PET/CT显像诊断前列腺癌的灵敏度为86.96%,特异性为88.24%,阳性预测值为90.91%。PET/CT同时发现了6例患者的盆腔淋巴结转移,4例骨转移,1例肺转移。结论:对于PSA升高的前列腺病变,11C-胆碱PET/CT显像不仅是一种鉴别良恶性的较好的无创性检查方法,而且可以有助于准确术前分期。
Objective: To investigate the value of 11C-choline PET / CT imaging in differential diagnosis and preoperative staging of benign and malignant prostatic diseases with elevated PSA levels. Methods: Forty patients with elevated PSA level underwent PET / CT imaging of supine position after intravenous injection of 0.2 mli / kg of 11C-choline for 5 minutes, and whole-body imaging was performed if necessary. The highest SUV (SUVmax) of the diseased and control tissues was measured and the ratio (P / M) was calculated. The imaging results were analyzed by semi-quantitative analysis. Results: The pathology confirmed benign prostatic hyperplasia and inflammation in 17 cases, 23 cases of prostate cancer. The difference between the P / M values of benign and malignant prostatic lesions was significant. With P / M> 2.14 as the standard, the sensitivity and specificity of 11C-choline PET / CT imaging for the diagnosis of prostate cancer were 86.96%, 88.24% and 90.91%, respectively. Six cases of pelvic lymph node metastases, four cases of bone metastases and one case of lung metastases were also found in PET / CT. CONCLUSIONS: 11C-choline PET / CT imaging is not only a good noninvasive method to differentiate benign from malignant, but also contributes to accurate preoperative staging in patients with elevated PSA.