肝反应性淋巴样组织增生18F-FDG PET/CT双时相显像表现

18F-FDG PET/CT dual-phase imaging characteristics of reactive lymphoid hyperplasia of liver

    摘要
  • 摘要:
    目的 探讨肝反应性淋巴样组织增生（RLH）的18F-氟脱氧葡萄糖（FDG） PET/CT双时相显像表现。
    方法 回顾性分析2016年9月至2021年7月于复旦大学附属中山医院行18F-FDG PET/CT双时相显像并经手术标本或穿刺组织病理学检查结果确诊为肝RLH的7例患者的临床资料和影像资料，其中男性2例、女性5例，年龄（60.4±3.7）岁。观察肝RLH的 18F-FDG PET/CT显像表现，分别测量及计算病灶长径、病灶与邻近肝脏的CT值、早期显像及延迟显像的最大标准化摄取值（SUVmax）、肝本底 SUVmax、滞留指数（RI）。符合正态分布的计量资料的比较采用两独立样本t检验。
    结果 7例肝RLH患者中，71.4%（5/7）患者为单发病灶、28.6%（2/7）患者为多发病灶，共11个病灶，均位于肝包膜下，其形态呈类圆形或椭圆形，边界模糊，长径5.5~19.2（14.9±1.2） mm。CT平扫结果显示，11个病灶密度均匀，其中2个病灶呈等密度，9个病灶呈低密度，其CT值为（42.1±3.1） HU，低于邻近肝实质的CT值（55.9±1.5） HU，且二者的差异有统计学意义（t=−7.36，Ρ<0.001）。18F-FDG PET/CT显像结果显示，63.6%（7/11）病灶的18F-FDG摄取高于肝实质，其中85.7%（6/7）病灶延迟显像的SUVmax升高，14.3%（1/7）病灶延迟显像的SUVmax降低，早期、延迟显像病灶的SUVmax分别为6.2±0.4和6.8±0.7，RI为12.2%（8.9%，15.5%）；36.4%（4/11）病灶的18F-FDG 摄取低于或邻近肝实质，延迟显像病灶的SUVmax无明显变化，早期、延迟显像病灶的SUVmax分别为2.2±0.4和2.1±0.4。
    结论 肝RLH病灶多位于肝包膜下，呈均匀稍低密度灶，边界模糊。18F-FDG PET/CT显像显示多数病灶18F-FDG高摄取，少数病灶呈等摄取或低摄取，延迟显像SUVmax多升高，多发病灶18F-FDG摄取相近或相差很大。

     

    Abstract:
    Objective To explore 18F-flurodexyglucose (FDG) PET/CT dual-phase imaging characteristics of reactive lymphoid hyperplasia (RLH) of the liver.
    Methods The clinical and imaging data of 7 patients with liver RLH diagnosed by 18F-FDG PET/CT dual-phase imaging in Zhongshan Hospital Affiliated with Fudan University from September 2016 to July 2021 were analyzed retrospectively. The patients comprised 2 males and 5 females, aged (60.4±3.7) years. The 18F-FDG PET/CT imaging findings of the lesions were observed. The length and diameter of the lesions, CT values of the lesions and the adjacent liver, maximum standardized uptake value (SUVmax), liver background SUVmax, and retention index (RI) were measured and calculated. The measurement data in accordance with normal distribution were compared by two independent sample t-test.
    Results Among the 7 patients with liver RLH, 71.4% (5/7) patients had a single lesion, whereas 28.6% (2/7) patients had multiple lesions, amounting to 11 lesions in total, all of which were located under the liver capsule. The shape of the lesions was quasi-round or oval, the boundary was blurred, and the length diameter of lesions was 5.5–19.2 (14.9±1.2) mm. The results of the CT plain scan showed that the density of 11 lesions was homogeneous, of which 2 lesions showed isodensity and 9 lesions were hypodense. The CT value of 11 lesions was lower than that of adjacent hepatic parenchyma (42.1±3.1) HU, which was lower than that of adjacent hepatic parenchyma (55.9±1.5) HU, and the difference between them was statistically significant (t=−7.36, P<0.001). The results of 18F-FDG PET/CT imaging showed that the 18F-FDG uptake of 63.6% (7/11) lesions was higher than that of liver parenchyma, of which SUVmax of 85.7% (6/7) lesions increased, and SUVmax of 14.3% (1/7) lesions decreased. The SUVmax values of early imaging and delayed imaging lesions were 6.2±0.4 and 6.8±0.7, respectively. RI was 12.2% (8.9%, 15.5%). The 18F-FDG uptake of 36.4% lesions was lower than or adjacent to the liver parenchyma, and SUVmax of delayed imaging had no significant change. SUVmax of early imaging and delayed imaging were 2.2±0.4 and 2.1±0.4, respectively.
    Conclusions Most of the liver RLH lesions were located under the liver capsule, showing homogeneous and slightly low-density lesions, and the boundary was blurred. 18F-FDG PET/CT imaging showed high 18F-FDG uptake in most lesions, equal or low uptake in a few lesions, increased SUVmax in delayed imaging, and similar or different patterns of 18F-FDG uptake in multiple lesions.

     

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