| 滕才钧,邓燕云,韦建林.18F-FDG PET/CT联合MR胰胆管造影多模态显像诊断良恶性梗阻性黄疸[J].中国医学影像技术,2019,35(3):390~394 |
| 18F-FDG PET/CT联合MR胰胆管造影多模态显像诊断良恶性梗阻性黄疸 |
| 18F-FDG PET/CT and MR cholangiopancreatography multimodal imaging in diagnosis of malignant and benign obstructive jaundice |
| 投稿时间：2018-08-05 修订日期：2018-12-19 |
| DOI：10.13929/j.1003-3289.201808031 |
| 中文关键词: 黄疸,阻塞性 氟脱氧葡萄糖F18 正电子发射断层显像术 体层摄影术,X线计算机 磁共振成像 |
| 英文关键词:jaundice,obstructive fludeoxyglucose F 18 positron-emission tomography tomography,X-ray computed magnetic resonance imaging |
| 基金项目:广西壮族自治区卫生和计划生育委员会计划科研课题（Z20170918）。 |
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| 中文摘要: |
| 目的 探讨18F-FDG PET/CT联合MR胰胆管造影（MRCP）多模态显像对良恶性梗阻性黄疸的诊断价值。方法 回顾性分析57例梗阻性黄疸患者的PET/CT与MRCP资料，根据最终诊断分为恶性梗阻组（n=31）和良性梗阻组（n=26），分析18F-FDG PET/CT与MRCP特征及多模态联合显像的诊断效能。结果 恶性梗阻组中，胰胆管中重度扩张13例（13/31，41.94%），良性梗阻组中，胰胆管中重度扩张1例（1/26，3.85%），差异有统计学意义（P=0.047）。恶性梗阻组病灶最大标准摄取值（SUVmax）为10.54±6.69，高于良性组（3.78±1.68；P<0.001）。18F-FDG PET/CT和MRCP诊断恶性梗阻性黄疸的灵敏度为90.32%（28/31）和61.29%（19/31），差异有统计学意义（P=0.046）；特异度为84.62%（22/26）和76.92%（20/26），差异无统计学意义（P=0.725）；准确率为87.72%（50/57）和68.42%（39/57），差异有统计学意义（P=0.013）。18F-FDG PET/CT联合MRCP多模态显像诊断恶性梗阻性黄疸的灵敏度、特异度和准确率分别为96.77%（30/31）、88.46%（23/26）和92.98%（53/57），与18F-FDG PET/CT比较差异均无统计学意义（P均>0.05），与MRCP比较，灵敏度、准确率差异有统计学意义（P=0.002、0.002），特异度差异无统计学意义（P=0.463）。18F-FDG PET/CT联合MRCP、18F-FDG PET/CT、MRCP诊断良恶性梗阻性黄疸与最终诊断结果的一致性Kappa值分别为0.858、0.752及0.375。结论 18F-FDG PET/CT联合MRCP多模态显像有利于提高梗阻性黄疸的诊断准确率，对诊断与临床治疗决策具有重要指导意义。 |
| 英文摘要: |
| Objective To investigate the diagnostic value of 18F-FDG PET/CT combined with MR cholangiopancreatography (MRCP) multimodal imaging in diagnosis of malignant and benign obstructive jaundice. Methods Totally 57 biliary obstruction patients were enrolled and divided into malignant obstruction group (n=31) and benign obstruction group (n=26). The diagnostic efficacy of 18F-FDG PET/CT, MRCP and multimodal imaging of obstructive jaundice were analyzed and compared. Results In malignant obstruction group, moderate to severe biliary expansion accounted for 41.94% (13/31), while in the benign obstruction group, the rate was 3.85% (1/26), and the difference between the two groups was statistically significant (P=0.047). The maximum standard uptake value (SUVmax) of malignant obstruction group (10.54±6.69) was significantly higher than that of the benign obstruction group (3.78±1.68; P<0.001). The sensitivity of 18F-FDG PET/CT and MRCP in diagnosis of malignant obstructive jaundice was 90.32% (28/31) and 61.29% (19/31), the difference was statistically significant (P=0.046); the specificity was 84.62% (22/26) and 76.92% (20/26), the difference was not statistically significant (P=0.725);the accuracy was 87.72% (50/57) and 68.42% (39/57), and the difference was statistically significant (P=0.013). The sensitivity, specificity and accuracy of 18F-FDG PET/CT combined with MRCP multimodal imaging in diagnosis of malignant obstructive jaundice were 96.77%(30/31), 88.46%(23/26) and 92.98% (53/57), respectively, the differences were not statistically significant compared with PET/CT (all P>0.05), while compared with MRCP, the differences in sensitivity and accuracy were statistically significant (P=0.002, 0.002), the difference in specificity was not statistically significant (P=0.463). Compared with final results, the Kappa coefficients of multimodality imaging, 18F-FDG PET/CT and MRCP were 0.858, 0.752 and 0.375, respectively. Conclusion 18F-FDG PET/CT combined with MRCP multimodal imaging is helpful to improvement of the diagnostic accuracy of obstructive jaundice, which has important guiding significance for diagnosis and clinical treatment decision-making. |
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