| 胡莹莹,林晓平,梁培炎,张旭,张伟光,樊卫.18F-FDG PET/CT在恶性黑色素瘤诊断及分期中的应用价值[J].中国医学影像技术,2009,25(4):685~688 |
| 18F-FDG PET/CT在恶性黑色素瘤诊断及分期中的应用价值 |
| Application of 18F-FDG PET/CT in diagnosis and staging of malignant melanoma |
| 投稿时间：2008-10-30 修订日期：2008-12-08 |
| DOI： |
| 中文关键词: 黑色素瘤 氟脱氧葡萄糖 正电子发射断层显像术 体层摄影术, X线计算机 肿瘤分期 |
| 英文关键词:Malignant melanoma 18F-fluorodeoxyglucose Positron emission tomography Tomography, X-ray computed Tumor staging |
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| 中文摘要: |
| 目的 探讨 18F-FDG PET/CT在恶性黑色素瘤诊断及分期中的应用价值。方法 回顾性分析61例恶性黑色素瘤患者18F-FDG PET/CT显像，对原发恶性黑色素瘤5例、原发灶未明的淋巴结转移性恶性黑色素瘤16例及恶性黑色素瘤原发灶(不全)切除40例，分别研究PET/CT诊断恶性黑色素瘤原发灶及转移瘤的应用价值。结果 5例原发恶性黑色素瘤病灶均异常摄取FDG， SUV 3.52～14.76，其中2例示区域淋巴结转移并经病理确诊。3例原发灶未明的淋巴结转移性恶性黑色素瘤经18F-FDG PET/CT检出原发灶，原发灶检出率18.75%，其中2例示远处多发转移；另2例患者临床体检发现原发灶，18F-FDG PET/CT未见原发征象。40例恶性黑色素瘤原发灶(不全)切除患者中，18F-FDG PET/CT诊断原发灶残留8例，经病理确诊5例，准确率62.50％；18F-FDG PET/CT示区域淋巴结转移7例，病理确诊5例，阳性预测价值 71.43％；18F-FDG PET/CT 示远处多发转移14例，远处转移率35.00％(14/40)；40例患者中，2例因PET/CT显像降低临床分期，11例提高分期，18例患者治疗方案改变。结论 18F-FDG PET/CT在恶性黑色素瘤准确分期方面有较大临床价值，但在淋巴结转移性恶性黑色素瘤寻找原发灶的价值有限。 |
| 英文摘要: |
| Objective To observe the application value of 18F-FDG PET/CT in diagnosing and staging of malignant melanoma. Methods Sixty-one patients with malignant melanoma underwent 18F-FDG PET/CT were enrolled and grouped according to different initial diagnosis: primary malignant melanoma (n=5), lymph node metastatic malignant melanoma without primary signs (n=16) and malignant melanoma with primary sites resection or partly resection (n=40). The application value of 18F-FDG PET/CT in diagnosing and staging were assessed separately. Results All 5 primary malignant melanoma sites had increased FDG uptake, the SUVs were 3.52－14.76; and regional lymph metastases were found in 2 patients among them and both were verified pathologically. In 3 of 16 patients with lymph node metastatic malignant melanoma, primary sites were detected, the primary detection rate was 18.75%. Distant metastases were found in 2 of these 3 patients, while 2 primary sites were found by clinical examination when PET/CT was false-negative. For the 40 malignant melanoma with primary sizes resection or partly resection, PET/CT showed suspicious residual in 8 patients, 5 were verified pathologically, the accuracy was 62.50%. Regional lymph metastases were found in 7 of these 40 patients, 5 were verified pathologically, the positive predictive value was 71.43%. In 14 of 40 patients, distant metastases were found (35.00%). With the use of PET/CT, the clinical stage was down-staged in 2 of 40 patients, up-staged in 11 patients, and therapies were changed in 18 of 40 patients. Conclusion 18F-FDG PET/CT is of great importance in whole body tumor staging of malignant malenoma, but is inefficient in detecting primary sites of lymph node metastatic malignant melanoma. |
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