PDF《F-FDG PET/CT 对骨骼孤立性高代谢病灶的》

国际放射医学核医学杂志 2015年1月第39卷第1期Int J Radiat Med Nucl Med, January 2015, Vol.

39, No.1 骨骼肿瘤在人群中的发病率较低,仅约为 0.01%,其中良性骨肿瘤占 50%,恶性骨肿瘤占 40%,骨肿瘤样病变占 10%.肿瘤以及肿瘤样病变 均可有 FDG 摄取[1-2] ,笔者在日常诊断工作中发现, DOI: 10.

3760 / cma. j. issn. 1673-4114. 2015. 01.

005 基金项目:2013 年度南方医院院长基金 (2013C005) 作者单位:510515 广州,南方医科大学南方医院 PET 中心 通信作者:王全师 (Email:[email protected])

18 F-FDGPET/CT 对骨骼孤立性高代谢病灶的 初步诊断价值 周文兰 吴湖炳 韩彦江 钟锦梅 王全师 【 摘要 】 目的 分析骨骼孤立性高代谢病灶的

18 F-FDG PET/CT 表现,以提高其诊断的水平. 方法 回顾性分析

22 例经病理学确诊的骨骼孤立性高代谢病灶的 PET/CT 征象.结果

22 例患者 中,淋巴瘤及嗜酸性肉芽肿各

5 例、浆细胞性骨髓瘤及骨肉瘤各

4 例、尤文氏肉瘤和 I 级骨巨细胞 瘤各

2 例.病灶平均 SUVmax 为11.08±8.06 (2.1~32.6) .良恶性病灶对 FDG 摄取的差异无统计学意义 (SUVmax:8.86±2.40 vs. 12.12±9.58,t=-1.241,P=0.231) .按病理类型进行分类,不同病理类型骨骼 病灶对 FDG 摄取的差异无统计学意义 (F=0.296,df=5,P=0.908) .浆细胞骨髓瘤及骨巨细胞瘤易出 现FDG 摄取不均.同机 CT 主要表现:溶骨性破坏

17 例,伴硬化边

5 例,形成"领结征" 、"皂 泡征" 、"花边征"等典型征象;

成骨性改变

5 例,见于淋巴瘤及骨肉瘤;

软组织肿块形成

17 例;

骨膜反应

4 例.结论 PET 难以对骨骼孤立性病灶进行定性,密切结合同机 CT 征象有助于诊断. 【 关键词 】 骨肿瘤;

诊断,鉴别;

正电子发射断层显像术;

体层摄影术,X 线计算机;

氟脱 氧葡萄糖 F18;

孤立性高代谢病灶 Preliminary study of

18 F-FDG PET/CT in the diagnosis of solitary hypermetabolic lesion of bone Zhou Wenlan, Wu Hubing, Han Yanjiang, Zhong Jinmei, Wang Quanshi. Department of PET Center, Southern Hospital, Southern Medical University, Guangzhou 510515, China Corresponding author: Wang Quanshi, Email: [email protected] 【Abstract】 Objective This study aims to investigate the clinical value of

18 F-FDG PET/CT in diagnosing solitary hypermetabolic lesion of the bone. Methods Twenty-two patients with solitary FDG uptake in the bone were enrolled. Patient diagnosis was confirmed by biopsy or surgery. PET/CT images were analyzed. Results Of the

22 patients,

5 had primary bone lymphoma and bone eosinophilic granuloma,

4 had plasma cell myeloma and osteosarcoma, and

2 had Ewing's sarcoma and giant cell tumor of the bone. The mean SUVmax of bone lesions is 11.08±8.06(2.1-32.6). Nineteen lesions had well- distributed FDG uptake. The other three lesions were unevenly distributed. No significant difference in FDG uptake was found between malignant and benign lesions (SUVmax: 8.86 ±2.40 vs. 12.12 ±9.58, respectively;

t=-1.241, P=0.231), and among different kinds of bone lesions(F=0.296, df=5, P=0.908). Syn-modality CT images showed that

17 patients have osteolytic changes,

5 of which with sclerosis edge. Some bone lesions presented as "bow tie sign", "soap bubble sign", and " lace sign". The other

5 patients,

3 with primary bone lymphoma and

2 with osteosarcoma, presented with ossification changes. Otherwise, soft tissue mass was formulated in

17 patients, and periosteal proliferation developed in