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目的 探讨水灌肠18F-FDG PET/CT检查在直肠癌诊断中的应用价值.方法 回顾性分析69例[男52例,女17例;平均年龄57.9岁]临床怀疑为直肠癌患者的常规及水灌肠18F-FDGPET/CT资料,与肠镜或术后病理结果进行对照,比较2种方法对直肠癌的诊断效能,同时比较不同病灶SUVmax的差异.采用配对t检验及McNemar检验对数据进行统计学分析.结果 病理证实直肠癌61例,非直肠癌8例.61例直肠癌患者灌肠前后SUVmax差异有统计学意义(13.17±6.19与14.25±6.63;t =-6.100,P＜0.01).常规PET/CT诊断直肠癌的灵敏度为90.2％(55/61),特异性为4/8,准确性为85.6％ (59/69);水灌肠PET/CT相应指标为98.4％(60/61),6/8,95.7％ (66/69),2种方法诊断直肠癌的准确性差异有统计学意义(x2=5.140,P＜0.05).结论 水灌肠PET/CT弥补了常规PET/CT的不足,提高了对直肠癌诊断的准确性.

Objective To investigate the diagnostic value of delayed water enema 18F-FDG PET/ CT for rectal cancer.Methods Sixty-nine cases (52 males,17 females; average age 57.9 years) with clinically suspected rectal cancer underwent routine and delayed water enema 18F-FDG PET/CT.The imaging results were compared with colonoscopy and surgical pathology.The diagnostic efficiency of the two imaging methods was compared and so was the SUVmax of lesions.Paired t and McNemar test were used to analyze the data.Results There were 61 rectal cancer cases confirmed by pathology.The SUVmax of rectal cancer calculated from routine and delayed water enema 18F-FDG PET/CT was significantly different (13.17± 6.19 vs 14.25±6.63; t=-6.100,P＜0.01).The sensitivity,specificity and accuracy of routine 18F-FDG PET/CT and delayed water enema 18F-FDG PET/CT in diagnosis rectal cancer were 90.2％ (55/61) vs 98.4％(60/61),4/8 vs 6/8,85.6％(59/69) vs 95.7％(66/69).A statistically significant difference was found in diagnostic accuracy between the two imaging methods (x2=5.140,P＜0.05).Conclusion The delayed water enema 18F-FDG PET/CT has a complementary diagnostic value for routine 18F-FDG PET/CT in rectal cancer.