Toriihara Akira, Yamaga Emi, Nakadate Masashi, Oyama Jun, Tateishi Ukihide
Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Jpn J Radiol. 2017 Sep;35(9):539-545. doi: 10.1007/s11604-017-0664-5. Epub 2017 Jul 3.
To evaluate the frequency of emergency diseases that were detected unexpectedly using FDG-PET/CT.
Interpretation reports for 11,663 FDG-PET/CT studies in our hospital were retrospectively reviewed. Patients with major emergency diseases were extracted according to the following exclusion criteria: (1) relevant findings had been recognized prior to the PET/CT; (2) an intervention or operation that may have been relevant to the present findings was performed within 1 month prior to the PET/CT; and (3) the clinical course could not be investigated sufficiently (e.g., in cases where the patients were introduced from other hospitals).
Forty-one patients (0.35%) with unexpected emergency diseases were identified. The most frequent disease was pneumothorax (8 patients), followed by chronic subdural hematoma (CSH) (7 patients), ureteral stone (7 patients), and abdominal aortic aneurysm (AAA) with a dirty fat sign or a high-attenuation crescent sign visualized on CT (4 patients). Nine patients (2 pneumothorax, 3 CSH, 1 cerebral hemorrhage, 1 acute cholecystitis, 1 acute pancreatitis, and 1 acute appendicitis) were hospitalized and/or underwent therapeutic intervention within 1 week after the PET/CT.
Although rare, an unexpected emergency disease requiring urgent management can be detected using FDG-PET/CT in oncology patients.
评估利用氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描（FDG-PET/CT）意外检测到的急诊疾病的发生率。
回顾性分析我院11663例FDG-PET/CT检查的解读报告。根据以下排除标准提取患有主要急诊疾病的患者：（1）PET/CT检查前已发现相关病变；（2）在PET/CT检查前1个月内进行了可能与当前检查结果相关的干预或手术；（3）无法充分调查临床病程（例如，从其他医院转诊的患者）。
共识别出41例（0.35%）患有意外急诊疾病的患者。最常见的疾病是气胸（8例），其次是慢性硬膜下血肿（CSH）（7例）、输尿管结石（7例）以及CT上可见脏脂肪征或高密度新月征的腹主动脉瘤（AAA）（4例）。9例患者（2例气胸、3例CSH、1例脑出血、1例急性胆囊炎、1例急性胰腺炎和1例急性阑尾炎）在PET/CT检查后1周内住院和/或接受了治疗干预。
尽管罕见，但在肿瘤患者中利用FDG-PET/CT可检测到需要紧急处理的意外急诊疾病。
