FDG-PET鉴别诊断胆囊小息肉样病变的可能性

Toshimori Koh M.D., Hiroki Taniguchi M.D., Satoshi Kunishima M.D., Hisakazu Yamagishi M.D.
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引用次数: 30

摘要

目的:讨论3例胆囊小息肉样病变,术前应用正电子发射断层扫描(PET)与18f标记的脱氧葡萄糖(FDG)成功鉴别其良恶性。方法与结果:第一例患者为47岁女性,胆囊息肉样病变为15 × 10 mm。FDG- pet检测未发现FDG摄取。组织病理学诊断为胆固醇息肉。第二例为56岁女性,胆囊颈部息肉样病变22 × 8 mm,眼底壁增厚。FDG- pet检测未发现FDG摄取。术后诊断为颈部假性瘤泥及眼底腺肌瘤病。第三例患者为77岁男性,胆囊息肉样病变为15 × 15 mm。PET显示胆囊部位有FDG摄取的病灶。组织病理学诊断为腺癌。局灶性FDG摄取是胆囊恶性肿瘤的唯一指标。结论:FDG-PET有望成为胆囊癌术前准确诊断的重要工具之一。
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Possibility of Differential Diagnosis of Small Polypoid Lesions in the Gallbladder Using FDG-PET

Purpose: We discuss three cases of patients with small polypoid lesions of gallbladder in which we successfully differentiated the malignancy or benignity preoperatively using positron emission tomography (PET) scanning with 18F-labelled deoxyglucose (FDG).

Methods and Results: The first case involves a 47-year-old woman who had a 15 × 10 mm polypoid lesion of the gallbladder. FDG-PET was performed and revealed no FDG uptake. The histopathological diagnosis was a cholesterol polyp. The second case is a 56-year-old woman who had a 22 × 8 mm polypoid lesion in the neck of the gallbladder and wall-thickening of the fundus. FDG-PET was performed and no FDG uptake was found. The postoperative diagnosis was pseudo-tumorous sludge in the neck and adenomyomatosis of the fundus. The third case is a 77-year-old man who had a 15 × 15 mm polypoid lesion in the gallbladder. PET revealed a focus of FDG uptake at the site of the gallbladder. The histopathologic diagnosis was adenocarcinoma. Focal FDG uptake was the sole indicator of a malignant tumor of the gallbladder.

Conclusions: FDG-PET may become one of the most useful tools for the accurate preoperative diagnosis of gallbladder carcinoma.

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