Abstract

Objective 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.Methods The 18F-FDG PET/CT features of 10 tuberculous peritonitis,13 primary serous papillary carcinoma of the peritoneum and 16 peritoneal metastases were retrospectively reviewed,which had been confirmed by clinic and / or histopathology.Four 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; (4)accompanying signs of other organs.Two sample t test was used to differentiate the 18F-FDG uptake of peritoneal lesions,the density and 18F-FDG concentration of ascites between tuberculous peritonitis and cancerous peritonitis.Results The typical 18F-FDG PET/CT features of tuberculous peritonitis was uniformity thickening of parietal peritoneum,mesenteric and omental stains like change,widely and even distribution of the peritoneal 18F-FDG,while the cancerous peritonitis was obvious uneven thickening of parietal peritoneum,mesenteric and omental nodules and pie-shape changes,uneven distribution of the peritoneal 18F-FDG.The 18F-FDG uptake was increased in all peritoneal lesions,and there are no significant difference between the tuberculous group (SUVmax=12.74±9.75) and the cancerous group (SUVmax=12.45 ±7.40) (t=0.099,P＞0.05).The density of malignant ascites[CTavg=(11.34±3.55) HU] was obvious lower than tuberculous ascites[CTavg=(14.4±2.37)HU] (t=2.5,P＜0.05).The 18F-FDG concentration in malignant ascites (SUVmax =2.10 ±0.65,T/NT =0.77 ±0.18) was obvious higher than tuberculous ascites (SUVmax=1.61±0.35,T/NT=0.58±0.12) (t=-2.278,-3.084,both P＜0.05).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 peritoneal lesions. Key words: Peritoneum; Neoplasms; Tuberculosis; Positron-emission tomography; Tomography,X-ray computed; Fluorodeoxyglucose F18

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