牛奶造影剂充盈法在18F-FDG PET/CT诊断胃癌中的增益价值

左 卫; 吴湖炳; 王全师; 李洪生; 周文兰; 董 烨

doi:10.11889/j.0253-3219.2014.hjs.37.120301

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牛奶造影剂充盈法在18F-FDG PET/CT诊断胃癌中的增益价值

核化学、放射化学、放射性药物和核医学 | 更新时间：2021-03-03

- 牛奶造影剂充盈法在18F-FDG PET/CT诊断胃癌中的增益价值
- Filling gastric cavity with milk and meglumini diatrizoate improves the value of 18F-FDG PET/CT for diagnosing the gastric cancer
- 核技术 2014年37卷第12期文章编号：120301
- 作者机构：
  
  南方医科大学南方医院PET中心,广州,510515
- 作者简介：
  
  [ "通讯作者: 王全师，E-mail: wqslph@163.net E-mail:wangquanshiwl@126.com" ]
- 基金信息：
  
  国家自然科学基金(No.81271645、No.81071174)资助()
- DOI：10.11889/j.0253-3219.2014.hjs.37.120301
  中图分类号：
- 纸质出版日期：2014-12-04
- 稿件说明：
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左卫, 吴湖炳, 王全师, 等. 牛奶造影剂充盈法在18F-FDG PET/CT诊断胃癌中的增益价值[J]. 核技术, 2014,37(12):120301

ZUO Wei, WU Hubing, WANG Quanshi, et al. Filling gastric cavity with milk and meglumini diatrizoate improves the value of 18F-FDG PET/CT for diagnosing the gastric cancer[J]. Nuclear techniques, 2014, 37(12): 120301
左卫, 吴湖炳, 王全师, 等. 牛奶造影剂充盈法在18F-FDG PET/CT诊断胃癌中的增益价值[J]. 核技术, 2014,37(12):120301 DOI： 10.11889/j.0253-3219.2014.hjs.37.120301.

ZUO Wei, WU Hubing, WANG Quanshi, et al. Filling gastric cavity with milk and meglumini diatrizoate improves the value of 18F-FDG PET/CT for diagnosing the gastric cancer[J]. Nuclear techniques, 2014, 37(12): 120301 DOI： 10.11889/j.0253-3219.2014.hjs.37.120301.

摘要

探讨牛奶造影剂充盈后延迟显像在18F-FDG PET/CT诊断胃癌中的增益价值。临床疑诊胃癌或须除外胃癌患者81例，在行18F-FDG PET/CT常规全身显像后，口服纯牛奶和复方泛影葡胺混合液500?600 mL充盈胃腔，10?20 min后进行胃局部延迟显像。肉眼分析比较胃腔充盈前后的图像差别，以手术和胃镜活检病理以及临床随访为确诊依据，评估牛奶造影剂充盈胃腔方法在PET/CT诊断胃癌中的增益价值。81例患者中，经病理确诊为胃癌者51例，良性病变30例。牛奶造影剂充盈胃腔后PET诊断胃癌的灵敏度从常规显像的60.7%提高至82.3% (?2 =5.829，P=0.016)，特异性从46.7%提高至76.6% (?2 =5.711，P=0.017)。综合分析PET和CT所见，CT弥补了6例(6/9)18F-FDG摄取不高的胃癌病灶的检出。常规显像和牛奶造影剂充盈胃腔后延迟显像PET/CT诊断胃癌的灵敏度分别88.2%、94.1%，特异性分别为83.3%、90.0%，二者的诊断效能无显著性差异(?2 =0.487，P=0.484和?2 =0.144，P=0.704)。牛奶造影剂充盈后延迟显像胃癌病灶及其侵犯范围的显示程度较空腹状态时更清楚(t=6.866，P=0.000)，在45.0% (23/51)弥漫型胃癌或18F-FDG摄取较低患者中提示CT的影像改变更有助于准确地显示和判断肿瘤的侵犯范围。18F-FDG PET/CT对原发性胃癌具有较高的诊断价值，采用牛奶造影剂胃充盈法尽管未能显著提高其诊断效能，却能更清晰地显示胃癌病灶及其侵犯范围。

Abstract

Background: 18F-FDG PET/CT has been considered of limited value for detection of gastric cancer because of the digestive physiological motility

physiological uptake and inaccurate alignment PET/CT image. Purpose: The aim is to investigate the value of 18F-FDG PET/CT for diagnosing the gastric cancer using milk and meglumini diatrizoate for filling gastric cavity. Methods: Eight-one patients

who were suspected to have or needed to exclude gastric cancer

underwent 18F-FDG PET/CT scans. All of them were orally administrated with the mixture of milk and meglumini diatrizoate for filling the gastric cavity after the finish of routine 18F-FDG PET/CT whole body imaging. 10?20 min later

regional PET/CT scan for the stomach was performed. The clinical role of PET and PET/CT with and without gastric cavity filling for diagnosing the gastric cancer was assessed visually based on the results of the histopathologic diagnosis and clinical following up. Results: 51 of the 81 patients were diagnosed to have gastric cancer and 30 have benign gastric diseases. After the gastric cavity filling

the sensitivity and specificity of PET for the gastric cancer were improved from 60.7% to 82.3% (?2=5.829

P=0.016) and from 46.7% to 76.6% (?2=5.711

P=0.017). By combined analysis of the morphological abnormality showed on CT and metabolic abnormality on PET

CT improved the diagnose of the gastric cancer in 6 patients with negative on 18F-FDG PET. However

the sensitivity of PET/CT for the gastric cancer before and after the gastric cavity filling were respectively 88.2%

94.1%

and the specificity were 83.3% and 90.0%

which was not significantly different (?2=0.487

P=0.484 and ?2=0.144

P=0.704). Filling gastric cavity with a mixture of milk and meglumini diatrizoate

the tumor lesion and the scope of tumor invasion can display more clearly (t=6.866

P=0.000)

in 45.0% (23/51) of gastric cancer patients with diffuse disease or low 18F-FDG uptake

which prompt that CT image change would help to more accurately display and judge the extent of violations. Conclusion: The method of gastric cavity filling with the milk and meglumini diatrizoate can eliminate the influence of gastric physically uptake and improve the visualization of the tumor lesion and the scope of tumor invasion

though it can not significantly improve diagnostic accuracy.Cited

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