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目的:探讨18F-FDG显像在泌尿系统恶性肿瘤转移病灶方面诊断的价值。方法:58例原发泌尿系统恶性肿瘤患者,其中肾脏透明细胞癌33例、肾脏肉瘤1例、膀胱移行细胞癌20例、输尿管移行细胞癌4例,进行常规18F-FDGPET/CT检查。所有病例均行独立的PET、CT评价,比较PET与CT在泌尿道肿瘤转移灶方面的诊断价值。所有病例均经过1年以上随访观察。结果:58例患者共发现68处病灶,最后证实为转移病灶共61处(45例患者)。PET敏感性为98.3%,特异性85.7%,阳性预测值98.36%,阴性预测值98.36%,准确性94%。CT敏感性为88.52%,特异性71.43%,阳性预测值96.43%,阴性预测值41.67%,准确性86.5%。PET/CT的敏感性为95%,特异性100%,阳性预测值100%,阴性预测值70%,准确性96.5%。结论:18F-FDGPET/CT融合显像对泌尿道肿瘤转移病灶的定性、定位诊断有更大的临床意义。
Objective: To investigate the value of 18F-FDG imaging in the diagnosis of metastatic malignant tumors in urinary system. Methods: Fifty-eight patients with primary urinary malignancy were enrolled, including 33 cases of renal clear cell carcinoma, 1 case of renal sarcoma, 20 cases of bladder transitional cell carcinoma and 4 cases of ureter transitional cell carcinoma. All cases were performed independent PET, CT evaluation, compare the diagnostic value of PET and CT in urinary tract tumor metastasis. All cases were followed up for more than 1 year. RESULTS: A total of 68 lesions were found in 58 patients and 61 were finally confirmed as metastatic lesions (45 patients). PET sensitivity was 98.3%, specificity 85.7%, positive predictive value 98.36%, negative predictive value 98.36%, accuracy 94%. CT sensitivity was 88.52%, specificity 71.43%, positive predictive value 96.43%, negative predictive value 41.67%, accuracy 86.5%. The sensitivity of PET / CT was 95%, the specificity was 100%, the positive predictive value was 100%, the negative predictive value was 70% and the accuracy was 96.5%. Conclusion: 18F-FDG PET / CT fusion imaging has more clinical significance in the diagnosis and localization of urinary tumor metastases.