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摘要：
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摘要：目的 探讨正电子发射-计算机断层显像（positron emission tomography-computer tomography，
PET-CT）在肝脏泡型棘球蚴病可切除性及切除范围中的应用价值。方法 以2017年8月至2019年12月于
青海省人民医院拟行手术切除的30例肝脏泡型棘球蚴病患者为研究对象。患者在术前1周内行增强计
算机断层扫描（computer tomography，CT）和PET-CT检查，由影像医师与外科医师共同分析两种图
像，明确病灶的可切除性及切除范围，术后进行病理分析，明确疾病类型。绘制增强CT和PET-CT诊
断肝脏泡型棘球蚴病的受试者工作特征（receiver operator characteristic，ROC）曲线，比较两种诊断
方法的敏感性、特异度及曲线下面积。结果 本组30例患者共计33个病灶（其中3例有2个病灶）。经
评估后，最终28例患者行手术切除，共完整切除28个病灶，其中26个病灶边界术前PET-CT图像显示
为环状糖代谢增高区域，术后病理证实22个为炎性浸润、成纤维细胞，4个为多房棘球蚴虫体。另外
2个病灶边界PET-CT图像显示为无糖代谢增高，术后病理证实为正常肝组织。增强CT和PET-CT的敏
感性（50.0% vs 100.0%）和阴性预测值（16.7% vs 100.0%）差异有统计学意义（P均＜ 0.05），特异
度（100.0% vs 100.0%）、阳性预测值（100.0% vs 100.0%）差异无统计学意义。增强CT和PET-CT的
ROC曲线下面积分别为0.769、1.000，差异有统计学意义（z = 4.629，P ＜ 0.001）。结论 PET-CT可
清晰显示肝脏泡型棘球蚴病灶的生物学活性边界，一次成像即可显示全身病灶，包括原发灶及远处转
移灶，对术前评估病灶可切除性及切除范围具有重要指导意义。
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Abstract: Objective To investigate the application value of positron emission tomography-computer tomography
(PET-CT) on the resectability and scope of hepatic alveolar echinococcosis. Methods Total of 30 cases with hepatic
alveolar echinococcosis who intended to undergo surgical resection in Qinghai Provincial People’s Hospital from
August 2017 to December 2019 were selected. Enhanced computed tomography (CT) and PET-CT examination
were performed within one week before surgery. The two images were analyzed by the radiologist and the surgeon
to determine the resectability and scope of the lesion, and the pathological analysis was carried out after operation
to determine the disease type. The receiver operator characteristic (ROC) curve of enhanced CT and PET-CT on the
diagnosis of hepatic alveolar echinococcosis was drawn. The sensitivity, specificity, accuracy and area under ROC
curve of the two methods were compared. Results A total of 33 lesions were found in 30 patients involved in this
study (3 of whom were with 2 lesions). After evaluation, 28 patients underwent surgical resection and complete
resection of 28 lesions, of which 26 lesions were with increased area of cyclic glucose metabolism shown by PET-
CT. Postoperative pathological showed that 22 were inflammatory infiltration and fibroblasts and 4 were multilocular
echinococcosis. Another 2 lesions had no increased area of cyclic glucose metabolism and were confirmed as
normal liver tissue by postoperative pathology. The sensitivity (50.0% vs 100.0%) and negative predictive value
(16.7% vs 100.0%) of enhanced CT and PET-CT were statistically significant (all P ＜ 0.05), the differences of
specificity (100.0% vs 100.0%) and positive predictive value (100.0% vs 100.0%) between the two methods were
not statistically significant. The area under the ROC curve of enhanced CT and PET-CT were 0.769 and 1.000,
respectively, the difference was statistically significant (z = 4.629，P ＜ 0.001). Conclusions PET-CT can clearly
show the biological activity boundary of hepatic alveolar echinococcosis lesions, and the lesions in the whole body
could be shown in one image, including primary and distant metastases, which is of great significance to evaluate the
resectability and scope of lesions before operation.
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