18F-FDG PET/CT与PET/MRI在结直肠癌肝转移诊断中的比较分析

Comparative analysis of 18F-FDG PET/CT and PET/MRI in the diagnosis of colorectal cancer liver metastases

    摘要
  • 摘要:
    目的 比较18F-氟脱氧葡萄糖（FDG） PET/CT与PET/MRI显像对结直肠癌肝转移的诊断价值。
    方法 回顾性分析2018年9月至2019年9月于宁波明州医院行全身18F-FDG PET/CT显像及上腹部18F-FDG PET/MRI显像，并疑似有结直肠癌肝转移的27例患者的临床资料，其中男性19例、女性8例，年龄28~78（60.6±12.2）岁。肝内病灶的最终诊断以组织病理学检查或影像学随访结果为参考标准，分别计算2种检查方法诊断结直肠癌肝转移瘤的灵敏度、特异度、准确率、阳性预测值和阴性预测值。根据肝转移病灶大小分长径≤1 cm、1 cm<长径≤2 cm、长径>2 cm 3组，分别计算各组的2种检查方法的灵敏度。采用McNemar检验比较2种检查方法诊断结直肠癌肝转移瘤的灵敏度、特异度和准确率；采用χ2检验比较2种检查方法诊断结直肠癌肝转移瘤的阳性预测值和阴性预测值。
    结果 基于27例结直肠癌患者分析，18F-FDG PET/MRI诊断肝转移瘤的灵敏度、准确率94%（15/16）、96%（26/27）均高于PET/CT81%（13/16）、89%（24/27），但差异均无统计学意义（McNemar检验，均P>0.05）。基于病灶分析，在27例结直肠癌患者中共发现118个肝内病灶，其中肝转移瘤病灶72个，18F-FDG PET/MRI诊断结直肠癌肝转移瘤病灶的灵敏度、准确率、阴性预测值85%（61/72）、91%（107/118）、81%（46/57）均高于PET/CT63%（45/72）、76%（90/118）、63%（45/72），且差异均有统计学意义（McNemar检验，χ2=5.072，均P<0.05）。对于长径≤1 cm的肝转移病灶，18F-FDG PET/MRI的诊断灵敏度63%（17/27）明显高于PET/CT7%（2/27），且差异有统计学意义（McNemar检验，P<0.05）。
    结论 与18F-FDG PET/CT相比，18F-FDG PET/MRI在结直肠癌肝转移中具有更高的诊断价值，尤其是在长径≤1 cm的病灶中。

     

    Abstract:
    Objective To compare the diagnostic values of 18F-fluorodeoxyglucose (FDG) PET/CT and PET/MRI in colorectal cancer liver metastases.
    Methods A retrospective analysis was performed on data collected from 27 patients with suspected colorectal cancer liver metastases, including 19 males and 8 females aged 28–78 (60.6±12.2) years old who underwent whole-body 18F-FDG PET/CT and upper abdomen 18F-FDG PET/MRI examination in Ningbo Mingzhou Hospital from September 2018 to September 2019. The result of histopathological examination and imaging follow-up served as the reference standards. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of both methods in the diagnosis of liver metastases were calculated. Liver metastases lesions were divided into three groups according to size: lesion length≤1 cm, 1 cm< lesion length≤2 cm, and lesion length>2 cm. The sensitivity of 18F-FDG PET/CT and PET/MRI in each group were calculated. McNemar test was used to compare the sensitivity, specificity, and accuracy of the two methods in the diagnosis of liver metastases. χ2 test was used to compare the PPV and NPV of the two methods in the diagnosis of liver metastases.
    Results Based on 27 patients with colorectal cancer analysis, the sensitivity and accuracy of 18F-FDG PET/MRI in the diagnosis of liver metastases (94% (15/16) and 96% (26/27)) were higher than those of PET/CT (81% (13/16) and 89% (24/27)), but the difference was not statistically significant (McNemar test, both P>0.05). Based on lesion analysis, mong the 118 liver lesions found in the 27 patients, 72 lesions were liver metastases and 46 lesions were benign liver lesions. The sensitivity, accuracy, and NPV of 18F-FDG PET/MRI in the diagnosis of liver metastases (85% (61/72), 91% (107/118) and 81% (46/57)) were significantly higher than those of PET/CT (63% (45/72), 76% (90/118) and 63% (45/72); McNemar test, χ2=5.072, all P<0.05). The sensitivity of 18F-FDG PET/MRI (63% (17/27)) for lesions with length≤1 cm was significantly higher than that of PET/CT (7% (2/27); McNemar test, P<0.05).
    Conclusion Compared with 18F-FDG PET/CT, 18F-FDG PET/MRI has higher diagnostic value in colorectal cancer liver metastases, especially for lesion with length≤1 cm.

     

    • HTML全文
    • 参考文献(23)
    • 相关文章
    • 施引文献
  • 资源附件(0)

/

返回文章
返回