中国癌症杂志 ›› 2014, Vol. 24 ›› Issue (7): 540-544.doi: 10.3969/j.issn.1007-3969.2014.07.012

• 论著 • 上一篇    下一篇

18F-FDG PET/CT显像中应用“反复排尿再充盈法”提高膀胱病灶检出率的临床研究

程竞仪1,杨忠毅1,张勇平1,王新村1,潘玲玲1,朱一平2,章英剑1   

  1. 1.复旦大学附属肿瘤医院核医学科,复旦大学上海医学院肿瘤学系,上海 200032;
    2.复旦大学附属肿瘤医院泌尿外科,复旦大学上海医学院肿瘤学系,上海 200032
  • 出版日期:2014-07-30 发布日期:2014-07-29
  • 通信作者: 章英剑 E-mail:yjzhang111@aliyun.com

Application of whole body 18F-FDG PET/CT plus additional delayed pelvic scan after oral hydration in the diagnosis of the bladder malignant lesions

CHENG Jing-yi1, YANG Zhong-yi1, ZHANG Yong-ping1, WANG Xin-cun1, PAN Ling-ling1, ZHU Yi-ping2, ZHANG Ying-jian1   

  1. 1. Department of Nuclear Medicine, Fudan University Shanghai Cancer Center ; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China;
    2. Department of Urology, Fudan University Shanghai Cancer Center ; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
  • Published:2014-07-30 Online:2014-07-29
  • Contact: ZHANG Ying-jian E-mail: yjzhang111@yahoo.com.cn

摘要:

背景与目的:18F-FDG经过由尿液排泄,膀胱中尿液的高放射性影响了膀胱病灶的检出,本研究介绍一种18F-FDG PET/CT检查中提高膀胱恶性病灶检出率的简便方法——“反复排尿再充盈法”,即:18F-FDG注射后反复饮水-排尿、最后憋尿检查。方法:回顾性分析了48(35例原发、13例非原发)膀胱恶性肿瘤患者18F-FDG常规显像后,通过反复饮水-排尿、再憋尿进行盆腔延迟显像的结果。结果:89%的患者(43/48)在首次延迟显像时,尿液SUVmax(SUV最大值)33.14(966.80)降至3.23(1.355.65),差异有统计学意义,(t=8.703, P<0.01)2次显像的平均间隔时间为2 h,而膀胱病灶的SUVmax2.825.0。该延迟显像方法对膀胱癌诊断灵敏度为90.5%(19/21)、特异度为81.5%(22/27)、准确性为85.4%(41/48)结论:反复饮水-排尿、最后憋尿情况下的盆腔延迟显像能在保持膀胱壁解剖对比的同时,有效降低膀胱尿液放射性本底、增加病灶靶/本比,进而增加膀胱癌灶检出率,且简单易行,值得推广。

关键词: 膀胱癌, 体层摄影术, 发射型计算机, 体层摄影术, X线计算机, 脱氧葡萄糖

Abstract:

Background and purpose: 18F-FDG has been considered to be of limited value for the detection of bladder lesions because of interference by the 18F-FDG excreted in urine. Delayed pelvic images with diluted and filled bladder use a method of 18F-FDG PET/CT with delayed images after oral hydration so as to increase the detection rate of 18F-fluorodeoxyglucose(FDG) PET/CT imaging for the lesions of bladder. Methods: 48 patients with bladder lesions(35 patients with bladder primary tumor and 13 patients with metastatic tumor) underwent 18F-FDG PET/CT detection and were required oral hydration of 1200-1800 mL water, urination frequently, holding urine when the more scan began. Lesions confirmed by histopathology, MRI, CT or clinical follow-up at least 1 year. Results: 89%(43/48) of patients were obtained good clearance and the urine SUVmax declined from 33.14(9-66.80)to 3.23(1.35-5.65) significantly and the statistical difference was significant (t=8.703, P<0.01). The interval time between two scan was 2 h approximately. At the same time, the SUVmax of bladder lesion was 2.8-25.0. Detection sensitivity, specificity and accuracy were 90.47%(19/21), 81.48%(22/27)and 85.41%(41/48), respectively. Conclusion: 18F-FDG activity in the bladder significantly decreased in most patients with diluted and filled bladder. The PET/CT scan can highly detect lesions of bladder tissues. Our method with high accuracy and better endurance could be applied to detect the lesions in bladder.

Key words: Urogenital neoplasms, Positron emission tomography, Computed X-ray tomography, 18F-fluorodeoxyglucose