探讨¹⁸F-氟脱氧葡萄糖（¹⁸F-FDG）的正电子发射计算机断层显像（PET）/CT延迟显像在原发性肝癌（肝癌）中的诊断价值。

回顾性分析2014年10月至2016年12月在中山大学附属第三医院接受诊治的80例肝癌患者临床资料。其中男62例，女18例；平均年龄（58±12）岁。根据肿瘤直径大小分为小肝癌组（30例）、结节肝癌组（23例）和大肝癌组（27例）。患者均签署知情同意书，符合医学伦理学规定。患者静脉注射¹⁸F-FDG造影剂40～60 min后行早期PET/CT显像，2 h后行延迟PET/CT显像，测定两次显像中病灶最大标准摄取值（SUV_max）。观察并比较小肝癌组、结节型肝癌组、大肝癌组的早期和延迟显像情况及不同时期显像变化。3组SUV_max比较采用单因素方差分析和LSD-t检验，两组比较采用t检验，率的比较采用χ²检验。

结节型肝癌组的早期像、延迟像SUV_max分别为5.1±1.9、5.5±2.3，明显高于小肝癌组的3.9±1.4、4.3±2.0（LSD-t=2.60，2.03；P<0.05）；而低于大肝癌组的6.9±2.6、8.5±2.9（LSD-t=-2.82，-4.08；P<0.05）。大肝癌组延迟像SUV_max明显高于早期像组（t=2.05，P<0.05）。大肝癌组延迟像SUV_max较早期像明显升高患者百分率为93%（25/27），明显高于小肝癌组、结节型肝癌组的53%（16/30）、61%（14/23） （χ²=10.85，7.28；P<0.05）。

随肿瘤直径增加，延迟像¹⁸F-FDG摄取明显增加，采用¹⁸F-FDG PET/CT延迟显像技术可提高肝癌尤其大肝癌的检出率。

To investigate the diagnostic value of ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET)/CT delayed imaging in the diagnosis of primary liver cancer.

Clinical data of 80 patients with primary liver cancer who were admitted to the Third Affiliated Hospital of Sun Yat-sen University between October 2014 and December 2016 were retrospectively analyzed. Among them, 62 cases were males and 18 were females, aged (58±12) years old on average. According to the tumor diameter, the patients were divided into the small liver cancer group (n=30), nodular liver cancer group (n=23) and large liver cancer group (n=27). The informed consents of all patients were obtained and the local ethical committee approval was received. PET/CT early imaging was performed on the patients at 40-60 min after they were intravenously injected with contrast agent ¹⁸F-FDG, and PET/CT delayed imaging was performed at 2 h later. The maximal standardized uptake values (SUV_max) of the lesions in two imagings were detected. The early imaging, delayed imaging and the imaging changes at different stages were observed and compared among three groups. The SUV_max values were compared among three groups using one-way analysis of variance and LSD-t test, and were compared between two groups using t test. The rates were compared using Chi-square test.

The SUV_max values of the early imaging and delayed imaging were respectively 5.1±1.9 and 5.5±2.3 in the nodular liver cancer group, significantly higher than 3.9±1.4 and 4.3±2.0 in the small liver cancer group (LSD-t=2.60, 2.03; P<0.05), whereas significantly lower than 6.9±2.6 and 8.5±2.9 in the large liver cancer group (LSD-t=-2.82, -4.08; P<0.05). The SUV_max value of the delayed imaging in the large liver cancer group was significantly higher than that of the early imaging (t=2.05, P<0.05). The percentage of patients with SUV_max values of the delayed imaging higher than that of the early imaging was 93%(25/27) in the large liver cancer group, significantly higher than 53%(16/30) in the small liver cancer group and 61%(14/23) in the nodular liver cancer group (χ²=10.85, 7.28; P<0.05).

The ¹⁸F-FDG uptake of the delayed imaging increases significantly along with the tumor diameter increases. Application of ¹⁸F-FDG PET/CT delayed imaging can elevate the detection rate of liver cancer, especially large liver cancer.