目的 评价¹⁸F-FDG PET/CT在胰腺腺癌术前评估中的价值及对治疗决策的影响。方法 回顾分析89例具有完整资料（包括腹部增强CT和¹⁸F-FDG PET/CT）且原发肿瘤经病理检查或活检证实为腺癌的胰腺癌患者的临床资料。其中29例被手术证实为有手术指征，60例被手术或随访证实为无手术指征。通过增强CT、¹⁸F-FDG PET/CT、增强CT结合¹⁸F-FDG PET/CT评估胰腺腺癌患者术前远处转移及手术指征，使用χ2检验比较3种方法的效能；评估增强CT结合¹⁸F-FDG PET/CT后对治疗决策的影响。结果 增强CT、¹⁸F-FDG PET/CT、增强CT结合¹⁸F-FDG PET/CT评估胰腺腺癌远处转移准确度分别为73.0%、88.8%、92.1%(χ2=14.2，P=0.001)，评估手术指征的准确度分别为68.5%、73.0%、85.4%(χ2=7.4，P=0.025)。在增强CT评估为有手术指征的57例患者中，28例被手术证实为无手术指征，结合¹⁸F-FDG PET/CT后准确发现了其中的15例无手术指征患者；而增强CT评估为无手术指征的29例患者均被手术或随访证实为无手术指征，增强CT结合PET/CT检查未改变评估结果。结论 对增强CT术前评估为有手术指征的胰腺腺癌患者，增加PET/CT检查是必要的。

Objective To assess the value of ¹⁸F-FDG PET/CT for pre-operative evaluation of pancreatic adenocarcinoma and its effects on the therapeutic decision. Methods A retrospective analysis of clinical dada on 89 patients with pathology or biopsy-proven primary pancreatic adenocarcinoma and complete hospital records [including abdominal contrast-enhanced CT (ce-CT) and ¹⁸F-FDG PET/CT]. 29 cases were proved by operations to have surgical indications and 60 cases were proved by operations or follow-ups to have no surgical indication. First, pre-operative distant metastases and surgical indications were assessed via ce-CT, ¹⁸F-FDG PET/CT, and ce-CT combined with ¹⁸F-FDG PET/CT for patients with pancreatic adenocarcinoma. The efficacy of three methods was compared with χ2 test. Second, the effects of ce-CT combined with ¹⁸F-FDG PET/CT on the therapeutic decision were assessed. Results The accuracy rates of ce-CT, ¹⁸F-FDG PET/CT, and ce-CT combined with ¹⁸F-FDG PET/CT for evaluating the distant metastasis of pancreatic adenocarcinoma were 73.0%, 88.8%, and 92.1%, respectively (χ2=14.2, P=0.001). The accuracy rates for evaluating the surgical indication were 68.5%, 73.0%, and 85.4%, respectively (χ2=7.4, P=0.025). Of 57 patients who were evaluated by ce-CT to have surgical indications, 28 were proved by operations to have no surgical indication and 15 of them were correctly identified by the combination of ¹⁸F-FDG PET/CT. Of 29 patients who were evaluated by ce-CT to have no surgical indication, all of them were proven by operations or follow-ups to have no surgical indication. Ce-CT combined with PET/CT did not change the evaluation results. Conclusion For patients with pancreatic adenocarcinoma who are pre-operatively evaluated by ce-CT to have surgical indications, ¹⁸F-FDG PET/CT examination is necessary.