FDG PET/CT Paradoxically Demonstrated a Bladder Tumor by Diuretic and Changing Image Gray Scale in a Suspicious Recurrent Colon Cancer with Hematuria Patient

膀胱腫瘤在早期和延遲正子斷層造影上呈反差影像表現之案例報告

何國維(Kuo-Wei Ho) ； 黃啟洲(Chi-Chou Huang) ； 高育琳(Yu-Lin Kao) ； 高潘福(Pan-Fu Kao) ； 翁瑞鴻(Jui-Hung Weng)

《核子醫學暨分子影像雜誌》 27卷2期 (2014/06) Pp. 131-136

https://doi.org/10.6332/ANMMI.2702.006

摘要

一位71歲因血清癌胚抗原升高及血尿而懷疑大腸癌復發的病患接受氟化去氧葡萄糖正子電腦斷層檢查，意外地在電腦斷層影像中發現膀胱左側壁有一個腫瘤。經由調整影像灰階對比後，此腫瘤在早期和使用利尿劑後的延遲正子造影上呈反差的影像表現，亦即早期影像中呈現冷區，而延遲影像中呈現熱區。此影像學的表現主要是由於使用利尿劑後大量減少了尿液中氟化去氧葡萄糖的濃度，使得具高氟化去氧葡萄糖攝取的膀胱腫瘤病灶得以清楚顯影。經手術切除後，證實此腫瘤為膀胱移行上皮細胞癌。

關鍵字

膀胱腫瘤 ； 大腸癌 ； 利尿劑 ； 正子斷層掃描

並列摘要

A 71-year-old man with history of sigmoid colon cancer after surgery underwent [F-18]-fluorodeoxyglucose (FDG) positron emission computerized tomography (PET/CT) scan for suspicious recurrence according to rising serum carcinoembryonic antigen (CEA) level and hematuria. Reviewing CT portion of PET/CT image revealed a bladder tumor at the left aspect of the urinary bladder. The tumor appeared by changing imaging scale as an FDG filling-defect at left aspect of urinary bladder on early image. After diuretic use and changing imaging scale, the bladder tumor became a hot spot on three-hour delayed image. After transurethral resection of bladder tumor, the pathology showed transitional cell carcinoma (TCC). The paradoxical demonstration of the bladder tumor on FDG PET/CT was discussed.

並列關鍵字

bladder tumor ； colon cancer ； dieresis ； PET/CT