【从业必读】你必须了解的PET-CT十大经典问题

admin · 发表于 2020-10-14 17:20:51

                  <blockquote><p><span>让天下没有难找的医疗器械服务信息！</span></p><p><strong><span>“医疗器械助手”</span></strong><span> 让一切触手可及！</span></p><p><p><img src="image/20201014/ac7c4c86bff3f0660e634292dc511095_1.jpg" /></p></p><p><span>点击图片</span><span><span></span><p><img src="image/20201014/c407fe90207c2622cc8e1dff32d28341_2.jpg" /></p><p><img src="image/20201014/c407fe90207c2622cc8e1dff32d28341_2.jpg" /></p><p><img src="image/20201014/c407fe90207c2622cc8e1dff32d28341_2.jpg" /></p></span></p><p><br  /></p></blockquote><p><br  /></p><section powered-by="gulangu"><section><section powered-by="gulangu"><section><section><p><span></span></p><section><section><span><strong><span>1、什么是PET-CT</span></strong></span></section></section><p><br  /></p><p><span>PET-CT是目前世界上<strong>最先进的核医学分子影像设备</strong>，中文称为正电子发射计算机断层/X 线计算机体层成像。</span></p><p><span><br  /></span></p><p><span>PET-CT等于PET+CT，包含<strong>PET（功能分子影像）与CT（解剖影像）的最优化组合</strong>；即同时具有PET和CT的功能，但它绝不是二者功能的简单叠加，</span>因为PET与CT优势互补，“1+1>2”。PET-CT除了具备PET和CT各自的功能外，其独有的融合图像，将PET图像与CT图像融合，可以同时反映病灶的代谢，可以早期诊断<span>疾病的同时，明显提高诊断的准确性。</span></p><p><br  /></p><p><p><img src="image/20201014/d8fd7dc1a4c73b924fe015252940a072_5.jpg" /></p></p></section></section></section></section></section><p><br  /></p><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section><section><span><strong><span>2、PET-CT长什么样子</span></strong></span></section></section><p><br  /></p></section></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><p><br  /></p><p><p><img src="image/20201014/ebce9de328a7f668a9226e2f265fe395_6.jpg" /></p></p><p><p><img src="image/20201014/f6f20b47ecff4b132b5a2dd8c6606e0d_7.jpg" /></p></p><p><p><img src="image/20201014/1f59bc719f16cc0bf8c072a8fe5ef915_8.jpg" /></p></p><p><br  /></p></section></section></section></section><section><section powered-by="gulangu"><section><section><section><span><strong><span>3、PET-CT如何工作</span></strong></span></section></section><p><br  /></p></section></section></section></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section></section><section></section></section></section><section powered-by="gulangu"><section><p><p><img src="image/20201014/950fe2170fdcb6d35b19617f6bfe7033_9.jpg" /></p></p><p><br  /></p></section></section><section powered-by="gulangu"><section><section><p><span><strong>PET-CT工作原理</strong></span></p><p><span><strong><br  /></strong></span></p></section></section></section><section powered-by="gulangu"><section><section><p><span>众所周知，恶性肿瘤细胞是人体内的“强盗”，绝大多数恶性肿瘤细胞具有高代谢特点，特别是恶性肿瘤细胞的分裂增殖比正常细胞快，能量消耗相应增加，葡萄糖为组织细胞能量的主要来源之一，恶性肿瘤细胞的异常增殖需要葡萄糖的过度利用，<strong>因此恶性肿瘤摄取的葡萄糖远远高于其它正常组织。</strong></span></p><p><span><br  /></span></p><p><strong><span>18F-FDG（氟脱氧葡萄糖）是葡萄糖的类似物，是临床最常用的显像剂；</span></strong><span>18F-FDG能反映体内葡萄糖利用状况。肿瘤细胞内可积聚大量18F-FDG，但是18F-FDG仅仅是葡萄糖类似物，肿瘤细胞摄取后不能进一步代谢，属于<strong>“只进不拉”</strong>，能在肿瘤细胞内积聚，<strong>经PET-CT显像可显示肿瘤的部位、形态、大小、数量及肿瘤内的放射性分布。</strong>同时肿瘤细胞的原发灶和转移灶具有相似的代谢特性，一次注射18F-FDG就能方便地进行全身显像，18F-FDG PET-CT全身显像对于了解肿瘤的全身累及范围具有独特价值。</span></p><p><span><br  /></span></p><p><span></span></p><section><section><span><strong><span>4、PET-CT能做什么</span></strong></span></section></section><p><br  /><span></span></p></section></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section></section></section></section></section><section powered-by="gulangu"><section><section><p><span>PET-CT在肿瘤方面的应用占其临床应用的90%以上，最常用的显像剂为18F标记的FDG（18F-FDG）。<strong>PET-CT的主要适应症概括为：</strong></span></p><p><span><br  /></span></p><p><strong><span> (1)  协助诊断</span></strong></p><p><span>　　对肿瘤高危人群，早期发现或排除肿瘤；</span></p><p><span>　　对肿瘤标志物不明原因升高，寻找肿瘤病灶所在；</span></p><p><span>　　对已发现可疑病变者，鉴别良、恶性；</span></p><p><span>　　对可疑肿瘤患者，指导选择最有价值的活检部位；</span></p><p><span>　　对已发现肿瘤转移者，寻找原发灶。</span></p><p><strong><span> (2) 指导治疗</span></strong></p><p><span>　　对恶性肿瘤患者，进行更准确分期；</span></p><p><span>　　肿瘤恶性程度分级和预后判断；</span></p><p><span>　　指导放疗计划靶区的设定。</span></p><p><strong><span> (3)  疗效评估和复发监测</span></strong></p><p><span>　　肿瘤肿瘤术后及放化疗后疗效的评估；</span></p><p><span>　　肿瘤残存病灶与坏死、纤维化组织的鉴别；</span></p><p><span>　　肿瘤治疗后寻找残存、复发或转移病灶；</span></p><p><span>       肿瘤复发的监测。</span></p><p><span><br  /></span></p><p><strong><span>PET-CT在非肿瘤方面也有巨大的临床应用</span></strong><span>，如神经精神系统、心血管系统等方面均有广泛的应用。如：PET-CT对癫痫灶准确定位及抑郁症、帕金森氏病、老年性痴呆等疾病的研究；心肌活力测定等。</span></p><p><span><br  /></span></p></section></section></section></section></section></section><section powered-by="gulangu"><section><p><p><img src="image/20201014/3cacb5c7e7225b7791f81354db97832a_10.jpg" /></p></p><p><br  /></p></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section><p><span></span></p><section><section><span><strong><span>5、PET-CT在肿瘤诊治方面优势在哪</span></strong></span></section></section><p><br  /></p></section><section></section></section></section></section><section powered-by="gulangu"><section><section><p><strong><span>PET-CT在肿瘤精准诊治、个体化医疗中的应用：</span></strong></p><p><span><br  /></span></p><p><span>1、肿瘤临床分期和再分期</span></p><p><span>2、肿瘤良、恶性的早期诊断与鉴别诊断</span></p><p><span>3、高危人群的早期肿瘤筛查</span></p><p><span>4、早期预测和评估放、化疗疗效</span></p><p><span>5、肿瘤残余和治疗后纤维组织形成或坏死的鉴别</span></p><p><span>6、寻找肿瘤原发灶</span></p><p><span>7、辅助放疗计划的制定</span></p><p><span>8、指导临床活检定位</span></p><p><span>9、评估恶性病变的分化程度及预后</span></p><p><strong><span><br  /></span></strong></p><p><strong><span>PET-CT在高危人群肿瘤筛查中的应用：</span></strong></p><p><span></span></p><p><span>随着生活水平的提高，人们的健康意识逐渐增强，对健康就有了更高要求。PET-CT能早期发现严重危害生命的肿瘤等疾病，在肿瘤发生发展的早期，通过代谢分子影像层面的检查尽早发现恶性肿瘤，作为肿瘤高危人群早期筛查的手段，PET-CT不仅能从解剖层面，更能从代谢层面精确寻找病灶，有利于达到<strong>早发现、早诊断、早治疗</strong>的目的。</span></p><p><span><br  /></span></p></section></section></section></section></section></section><section powered-by="gulangu"><section><p><p><img src="image/20201014/e112f84874fad248ec8119dfc5b407e8_11.jpg" /></p></p><p><br  /></p></section></section><section powered-by="gulangu"><section><section></section><section></section><section></section><section></section><section></section></section></section><section powered-by="gulangu"><section><section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><p><span></span></p><section><section><span><strong><span>6、PET-CT检查流程是怎样的</span></strong></span></section></section><p><br  /></p></section></section></section></section></section></section></section></section></section></section><section powered-by="gulangu"><section><p><p><img src="image/20201014/b9326f0eed7560fcf8a3b8a9eb253dc6_12.jpg" /></p></p><p><br  /></p></section></section><section powered-by="gulangu"><section><section></section><section></section><section></section><section></section><section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><p><span></span></p><section><section><span><strong><span>7、PET-CT检查要做哪些准本</span></strong></span></section></section><p><br  /></p></section></section></section></section></section></section></section></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><p><span><strong>（1）禁食</strong></span></p><p><span>为了检查出正确的数据，检查前6小时禁止进食。水或无糖茶类可以喝，但请避免饮用含糖饮料。请不要吃糖果和口香糖之类含糖小食。糖分会使药物集中于肌肉中，使得疾病难以发现。<br  /><strong><span>（2）水的摄入</span></strong></span></p><p><span>检查前20-30分钟，摄入约500毫升水。通过排尿将身体中多余的水份和药物代谢出体外，使得拍摄画质更利于观察。<br  /><strong><span>（3）FDG注射</span></strong></span></p><p><span>FDG(氟代脱氧葡萄糖)通过例如肘部等处的静脉注射。具体注射部位，由检查负责人判断，请予以配合。</span></p><p><strong><span>（4）休息</span></strong></p><p><span>注射后如果过多运动，会使得药物集中于全身肌肉等部位，患病部位与正常部位难以区分。因此，请于注射后一小时内，在等待室内安静休息。并且，请在检查前一日，避免剧烈运动。<br  /><strong><span>（5）排尿</span></strong></span></p><p><span>注射后药物会通过尿排出体外，身体中有尿时做检查，可能会导致疾病被隐藏无法发现。因此，请在注射前去洗手间排尿清空膀胱，再做检查。<br  /><strong><span>（6）图像采集</span></strong></span></p><p><span>检查中将使用PET-CT进行全身拍摄。您会躺在检查床上20～50分钟左右，请在检查过程中尽量保持身体不要移动，身体的移动会导致无法获得有效图像，从而难以判断病灶。</span></p><p><strong><span><br  /></span></strong></p><p><strong><span>Tips：</span></strong></p><p><span>1、如果您是孕妇，一般不建议行PET-CT检查。<br  />2、检查中有任何不舒服的地方，请不要移动身体的同时大声说出您的不适之处。<br  />3、PET-CT装置中，设有声音采集装置，只要您及时发声，负责人马上就会赶到。<br  />4、如果您有幽闭恐惧症，请在检查前咨询工作人员。</span></p><p><span><br  /></span></p></section></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><p><span></span></p><section><section><span><strong><span>8、PET-CT检查后需要注意什么</span></strong></span></section></section><p><br  /></p></section></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><p><img src="image/20201014/4a63cc0fc06814035b1917d5260e0c2b_13.jpg" /></p></p><p><br  /></p></section></section></section><section><section powered-by="gulangu"><section><section><p><span>（1）</span><span>尽量<strong>多喝水</strong>，以利于18F-FDG显像剂排出体外；</span></p><p><span>（2）一般检查完后，建议<strong>短时间内最好不要接触孕妇和婴儿；</strong></span></p><p><span>（3）接受检查的病人如有特殊情况，应主动向PET-CT中心的医务人员说明情况，以便医务人员能进行针对性的指导。</span></p><p><span>（4）因常规使用的PET/CT显像剂18F-FDG几乎不从乳汁中分泌，但因哺乳期乳腺组织可摄取18F-FDG，在注射药物后的12小时内，最好避免与婴儿的接触，可<strong>选用其它方式进行喂乳。</strong></span></p></section></section></section></section><section></section></section></section></section></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section><p><span><br  /></span></p><p><span></span></p><section><section><span><strong><span>9、PET-CT的辐射有多大</span></strong></span></section></section><p><br  /></p></section><section></section></section></section></section><section powered-by="gulangu"><section><section><p><span>PET-CT注射的显像剂一般都是18F标记物(当然还有其他的核素代替18F)，它是一种医用显像剂，辐射剂量是十分细微的，并且衰变和排泄极快。一般2-3个小时就可以排出体外。在检查的时候注射进去的18F是按照公斤、体重计算药量的，<strong>大概是每公斤0.12mCi-0.15mCi，</strong>如果体重是60公斤，大概的放射剂量也就是不到10mCi的剂量。<br  /></span></p><p><span><br  /></span></p><p><strong><span>全身PET-CT 检查的辐射量由PET的辐射和CT的辐射构成，PET的辐射约为6-7mSv/次</span></strong><span>，常用的低剂量模式的CT辐射量平均也在6mSv/次之内。PET-CT辐射剂量增加主要取决于CT的扫描模式。<strong>所以一次PET-CT检查的辐射剂量约相当于一次腹盆部CT或增强CT的剂量。因此，PET-CT检查是安全的。  </strong></span></p><p><span><br  /></span></p></section></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><p><p><img src="image/20201014/602a5c466553791fed956f678267655e_14.jpg" /></p></p><p><p><img src="image/20201014/8c914ee23010df80fe877a82538b2002_15.jpg" /></p></p><p><br  /></p></section></section></section></section></section><section powered-by="gulangu"><section><section><section powered-by="gulangu"><section><section><section><p><span></span></p><section><section><span><strong><span>10、PET-CT是万能的吗</span></strong></span></section></section><p><br  /></p></section><section></section></section></section></section><section powered-by="gulangu"><section><section><p><span>尽管PET-CT是当前最先进的诊断设备之一，但<strong>PET-CT不是万能的，</strong>由于FDG同样可以被炎症、生理性等摄取，及部分肿瘤FDG代谢的异质性，所以<strong>PET-CT同样存在着假阳性、假阴性，临床上良恶性的诊断并不能百分之百通过PET-CT明确。</strong></span></p><p><span><br  /></span></p><p><span>PET-CT并不能完全取代诊断性CT、MRI、胃肠镜甚至超声等其他相关检查。每项检查都有其优势。有时候在做PET/CT检查时，医生还会要求病人进一步进行CT、MRI甚至超声等相关检查或病理进一步明确。</span></p></section></section></section></section></section></section><p><br  /></p><p><span>来源：</span><span>放射沙龙</span></p><section data-id="1658"><section><section><section data-id="1658"><section><section><section data-id="1658"><section><section><section data-id="1658"><section><section><p><span><strong>相关阅读</strong></span></p></section><p><p><img src="image/20201014/ec237188ae1e9c03eb4d9814f31b18ab_16.gif" /></p></p><p><span>『微课堂』CT、PET、MR有何区别？</span></p><p><br  /></p><p><span>【盘点】国产PET-CT品牌哪家强？</span></p><p><br  /></p><p><span>健康人是否适合做PET-CT？——揭开PET-CT检查的辐射真相</span></p><p><br  /></p><p><span>【精准诊断】挡不住的国产PET/CT新锐</span></p><p><br  /></p><p><span>【中国智造】PET-CT的新锐</span></p><p><br  /></p><p><span>PET-CT辐射到底有多大?</span></p></section></section><p><br  /></p></section></section></section></section></section></section></section></section></section><p><p><img src="image/20201014/ddc723b50bcaa3c373cb35a0033daacd_17.jpg" /></p></p>

		自动登录	找回密码
密码			立即注册