Value of 18F-FDG PET/CT in the Differential Diagnosis of Diffuse Tuberculous Peritonitis and Peritoneal Metastases
Objective To investigate the value of positron emission computed tomography(18F-FDG PET/CT)using glucose as a developing agent in the differential diagnosis of diffuse tuberculous peritonitis(TBP)and peritoneal metastases(PM).Methods A total of 80 patients with diffuse peritoneal lesions who underwent positron emission computed tomography(PET/CT)examination in our hospital from January 1,2016 to December 31,2022 were selected as the study objects.Taking pathological examination or surgery as the gold standard,the patients were divided into TBP group(20 cases in group A)and PM group(60 cases in group B).The types of glucose(FDG)metabolic distribution,types of peritoneal thickening,focal diameter,maximum standardized intake value of omental/mesenteric/parietal peritoneal effusion(SUVmax)and peritoneal effusion T/NT were compared between the two groups.Receiver operating characteristic(ROC)curves of omental SUVmax,peritoneal effusion SUVmax and peritoneal effusion T/NT were plotted to evaluate the optimal critical values for diagnosing TBP and PM.Results There was no statistical significance in the distribution of FDG metabolism in parietal peritoneum between 2 groups(P＞0.05).The metabolic distribution of FDG in mesentery and omentum in group A was diffuse,while that of FDG in group B was localized(P＜0.05).The comparison of peritoneal lesion morphology between the two groups showed that the patients with uniform parietal peritoneal thickening and smudge-like thickening in group A were significantly more than those in group B,and the patients with cake thickening were significantly less than those in group B(P＜0.05).There was no statistical significance in nodular and lump-like thickening between the two groups(P＞0.05).Most of the lesions in group A were less than 3.00cm in diameter,most of the lesions in group B were more than 3.00cm in diameter,and the average lesion diameter in group B was(3.88±0.79)cm,which was significantly higher than that in group A(2.56±0.53)cm(P＜0.05).There was no statistical significance in parietal peritoneal SUVmax between the two groups(P＞0.05).The greater omental membrane,mesentery SUVmax,peritoneal effusion SUVmax and peritoneal effusion T/NT in group B were significantly higher than those in group A,and the CT value of peritoneal effusion was lower than that in group A(P＜0.05).The area under T/NT curve of peritoneal effusion was the largest(0.965),and the area under SUVmax curve of omentum was the smallest(0.808).The optimal critical values of T/NT of peritoneal effusion,SUVmax of peritoneal effusion and SUVmaxof omentum were 0.63,1.79 and 12.36,respectively,for distinguishing TBP from PM.Conclusion 18F-FDG PET/CT has the highest sensitivity in the detection of T/NT from diffuse TBP and PM,and has high diagnostic value.
Tuberculous PeritonitisPeritoneal MetastasesPositron Emission Computed TomographyDiagnostic Value
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