Highly metabolic thrombus of the portal vein:^(18)F fluorodeoxyglucose positron emission tomography/computer tomography demonstration and clinical significance in hepatocellular carcinoma

作     者：Long Sun Yong-Song Guan Wei-Ming Pan Gui-Bing Chen Zuo-Ming Luo Ji-Hong Wei Hua Wu 

作者机构：Minnan PET: Center The First Hospitalof Xiamen Fujian Medical University Xiamen 316003 FujianProvince China West China Hospital of Sichuan UniversityChengdu China 610041 State Key Laboratory of BiotherapyWest China Medical School Sichuan University Gaopeng StreetKeyuan Road 4 Chengdu 610041 Sichuan Province China 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2008年第14卷第8期

页      面：1212-1217页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：肝细胞癌 诊断 正电子发射X射线层析照相术 计算机X线断层摄影术 门静脉血栓 

摘      要：AIM:To assess the ability of 18F-fluorodeoxyglucose positron emission tomography/computer tomography (18F-FDG PET/CT) to differentiate between benign and malignant portal vein thrombosis in hepatocellular carcinoma (HCC) patients. METHODS:Five consecutive patients who had HBV cirrhosis, biopsy-proven HCC, and thrombosis of the main portal vein and/or left/right portal vein on ultrasound (US), computer tomography (CT) or magnetic resonance imaging (MRI) were studied with 18F-FDG PET/CT. The presence or absence of a highly metabolic thrombus on 18F-FDG PET/CT was considered diagnostic for malignant or benign portal vein thrombosis, respectively. All patients were followed-up monthly with US, CT or MRI. Shrinkage of the thrombus or recanalization of the vessels on US, CT or MRI during follow-up was considered to be definitive evidence of the benign nature of the thrombosis, whereas enlargement of the thrombus, disruption of the vessel wall, and parenchymal infiltration over follow-up were considered to be consistent with malignancy. 18F-FDG PET/CT, and US, CT or MRI results were compared. RESULTS:Follow-up (1 to 10 mo) showed signs of malignant thrombosis in 4 of the 5 patients. US, CT or MRI produced a true-positive result for malignancy in 4 of the patients, and a false-positive result in 1. 18F-FDG PET/CT showed a highly metabolic thrombus in 4 of the 5 patients. 18F-FDG PET/CT achieved a true-positive result in all 4 of these patients, and a true-negative result in the other patient. No false-positive result was observed using 18F-FDG PET/CT. CONCLUSION:18F-FDG PET/CT may be helpful in discriminating between benign and malignant portal vein thrombi. Patients may benefit from 18F-FDG PET/CT when portal vein thrombi can not be diagnosed exactly by US, CT or MRI.