The Value Of ¹⁸F-FDG PET/CT In Diagnosis Of Diffuse Peritoneal Lesions

Objective 1.To analysis the ¹⁸F-FDG PET/CT features of tuberculous and cancerous diffuse peritoneal lesions and evaluate the value of ¹⁸F-FDG PET/CT in diagnosing and differentiating the lesions.2.To study the application value of PET/CT in finding the primary tumor lesion of metastatic peritoneal carcinoma.Materials and methods 1.The ¹⁸F-FDG PET/CT features of 72 tuberculous peritonitis,28 primary serous papillary carcinoma of the peritoneum and 135 peritoneal metastases were retrospectively reviewed,which had been confirmed by clinic and/or histopathology.Three indicators were observed and graded:?1?¹⁸F-FDG PET/CT features of parietal peritoneum,greater omentum and mesentery;?2?features of ascites;?3?enlargement of lymph nodes.Two sample t test was used to differentiate the ¹⁸F-FDG uptake of peritoneal lesions,the density and¹⁸F-FDG concentration of ascites between tuberculous peritonitis and cancerous peritonitis.2.To analysis the imaging characteristics of PET/CT and CT for 93 patients with undetermined origin of ascites,who were diagnosed peritoneal carcinomatosis.The efficiency of PET/CT and CT were evaluated and McNemar's test was apply to test.Results Uniformity thickening of parietal peritoneum,mesenteric and omentalstains like change,widely and even distribution of the peritoneal ¹⁸F-FDG was the typical¹⁸F-FDG PET/CT features of tuberculous peritonitis,while the cancerous peritonitis was obvious uneven thickening of parietal peritoneum,mesenteric and omental nodules and pieshape changes,uneven distribution of the peritoneal ¹⁸F-FDG.The¹⁸F-FDG uptake was increased in all peritoneal lesions,and there are no significant difference between the tuberculous group(SUV_max=10.53±5.44)and the cancerous group(SUV_max=11.45±6.78)?t=-1.017,P>0.005?.The density of malignant ascites[CT_avg=?11.10±3.40?HU]wasobviouslowerthantuberculousascites[CT_avg=?13.92±2.84?HU]?t=6.147,P<0.05?.The ¹⁸F-FDG concentration in malignant ascites(SUV_max=1.88±0.65,T/NT=0.73±0.18)was obvious higher than tuberculous ascites(SUV_max=1.67±0.69,T/NT=0.57±0.27)?t=-2.243,-5.045,both P<0.05?.2.By studying the results of laparoscopy,the liver biopsy,gastroscopic or endoscopic biopsy,surgical,the primary lesions were found in 82 patients with peritoneal cacinomatosis among 93 patients.The primary tumor lesions of other 11 cases after laparoscopicexamination,operation and other inspection method,were still not clear.PET/CT detected the primary tumors in 78 patients accurately in 82 patients with clear primary tumors.3 patients of gastric signet-ring cell carcinoma and one patient of cecal low differentiated signet-ring adenocarcinoma were false-negative on PET/CT imaging.The plain CT can detecte the primary tumors in 53 patients.The rate of PET/CT in detecting the primary lesions was 95.1%,which was much higher than that of CT?64.6%???²=25.04,P=0.000?.Conclusion The ¹⁸F-FDG PET/CT imaging can show the morphology and metabolic changes of peritoneal lesions,and fully display the lesions in the whole body.It is important to analyze ¹⁸F-FDG PET/CT features of disuse peritoneal lesions in order to improve the accuracy of diagnosing the diffuse peritonea lesions.