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目的 探讨18 F-脱氧葡萄糖(FDG)早期显像及利尿延迟显像在肾癌诊断中应用价值.方法 选取2016年1月至2017年12月沈阳军区总医院核医学科收治的PET/CT、超声等影像学诊断疑似肾癌的30例患者,均行18 F-FDG PET/CT早期-利尿双时像显像,测量两次显像病灶处的最高标准摄取值(SUVmax),并对双时显像的诊断效能进行分析.结果 肾细胞癌(RCC)25例,原发良性占位1例,炎性病变1例,转移瘤3例.RCC早期显像SUVmax值与利尿延迟SUVmax值比较,差异有统计学意义(P=0.004).早期PET/CT显像灵敏度为68.0％,特异性为100％,准确性为73.3％,阳性预测值为100％,阴性预测值为38.5％.利尿延迟显像灵敏度为92.0％,特异性为100％,准确性为93.3％,阳性预测值为100％,阴性预测值为71.4％.对早期显像SUVmax值及利尿延迟显像SUVmax值分别与病灶直径进行线性相关性分析,早期显像r=0.141,P=0.502,利尿延迟显像r=0.168,P=0.373.结论 18 F-FDG PET/CT早期-利尿延迟显像对于肾肿瘤有一定诊断价值,有助于对于肾恶性病变初步病理分级及分期.

Objective To investigate the potential value of delayed diuretic 18 F-FDG PET/CT scan for differentiating renal lesions. Methods A total of 30 patients with renal lesions underwent 18 F-FDG PET/CT early-delayed imagings before surgical treatment or transrectal needly biopsy. After attenuation cor-rection and iterative reconstruction,PET image datas were analyzed semi-quantiatively by measuring maxi-mum standardized uptake values ( SUVmax ) in renal lesions. Results There were 25 cases of renal cell car-cinoma ( RCC) ,1 case of primary benign space occupying,1 case of inflammatory lesions and 3 cases of metastatic tumor. The SUVmax value of early imaging of RCC was compared with that of delayed diuretic SUVmax(P=0. 004). Early PET/CT imaging sensitivity was 68. 0％,specificity was 100％,accuracy was 73. 3％,positive predictive value was 100％ and negative predictive value was 38. 5％. The sensitivity of delayed diuretic imaging was 92. 0％,specificity was 100％,accuracy was 93. 3％,positive predictive value was 100％ and negative predictive value was 71. 4％. Linear correlation analysis was performed for SUVmax value of early imaging and SUVmax value of delayed diuretic imaging and lesion diameter,respectively. Early imaging r=0. 141,P=0. 502,delayed diuretic imaging r=0. 168,P=0. 373. Conclusion The 18 F-FDG PET/CT early diuretic delayed imaging has certain diagnostic value for renal tumors,and is helpful for the preliminary pathological grade and staging of renal malignant lesions.