18F-FDGPET/CT对骨骼孤立性高代谢病灶的初步诊断价值

Preliminary study of 18F-FDG PET/CT in the diagnosis of solitary hypermetabolic lesion of bone

    摘要
  • 摘要:
    目的 分析骨骼孤立性高代谢病灶的18F-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±2.40vs. 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。

     

    Abstract:
    objective This study aims to investigate the clinical value of 18F-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±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±40 vs. 12.12±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", "oap 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 4 patients.
    Conclusion Syn-modality CT images should be included in the differential diagnosis of solitary hypermetabolic lesion of the bone.

     

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