Objective To clarify the characteristics of fluorine - 18 fluorodeoxyglucose positron emission tomography/ compu-ted tomography(18 F - FDG PET/ CT)findings of linitis plastica,and explore the application value of 18 F - FDG PET/ CT in dif-ferential diagnosis of linitis plastica and normal gastric cavity with poorly water filling. Methods The characteristics of 18 F -FDG PET/ CT findings in 18 patients with linitis plastica confirmed by pathology. The standardized uptake value - maximum (SUVmax)of the gastric wall was calculated and compared with 46 cases of normal gastric cavity with poorly water filling. Re-sults Among the 18 cases of linitis plastica,12 cases showed low to moderate level of 18 F - FDG uptake. 9 cases of linitis plas-tica were confirmed by PET/ CT and 2 cases were misdiagnosed as physiological uptake. Other 7 cases could not be differentiated from physiological uptake or inflammatory. There was no significant difference in SUVmax before water intake between linitis plas-tica and normal gastric cavity(Z = - 0. 829,P = 0. 407). After water intake,the change of SUVmax in linitis plastica group was not obvious,and the FDG intake of gastric wall in patients with normal gastric cavity with poorly water filling was significantly de-creased( Z = - 5. 126,P = 0. 001). Conclusion 18 F - FDG PET/ CT could not effectively distinguish physiological uptake of poorly gastric filling from linitis plastica. Water intake may be useful to prevent misdiagnosis. The diagnostic value of this tech-nique based on SUVmax is limited. For patients with gastric wall thickening diagnosed by CT,18 F - FDG PET/ CT examination after water intake may be the good choice to advoid missed diagnosis.%目的：研究皮革胃的18 F - FDG PET/ CT 图像特点，探讨18 F - FDG PET/ CT 在皮革胃与胃充盈不良鉴别诊断中的应用价值。方法回顾性分析18例经病理证实的皮革胃患者的18 F - FDG PET/ CT 图像特征，统计胃壁 SUVmax，并与46例胃充盈不良的体检者进行比较。结果18例皮革胃患者中，有12例胃 FDG 摄取不高或仅有轻度摄取。PET/ CT能明确诊断胃癌者仅9例，误诊为生理性摄取者2例，7例结果不能与生理性摄取或炎症鉴别。皮革胃与胃充盈不良者两组间补充饮水前 SUVmax 差异无统计学意义（Z =-0.829，P =0.407）；补充饮水后皮革胃组 SUVmax 变化不明显，而胃充盈不良者胃壁 FDG 摄取减低，两组间 SUVmax 差异有统计学意义（Z =-5.126，P =0.001）。结论18 F - FDG PET/CT 检查对皮革胃 FDG 的摄取与胃充盈不良时胃壁的 FDG 生理性摄取鉴别困难，补充饮水是鉴别两者的简单方法。对CT 怀疑胃壁增厚患者，建议补充饮水后再次进行18 F - FDG PET/ CT 检查，以避免漏诊。
展开▼
