摘要
目的：探讨^(18) 氟-氟代脱氧葡萄糖-正电子发射计算机断层显像(fluorine-18fluorodeoxyglucose positron emission tomography，^(18) F- FDG PET)在淋巴瘤分期和疗效评价中的应用价值。方法：回顾分析45例淋巴瘤患者(治疗前23例，治疗后22例)^(18) F-FDG PET 检 测淋巴结和结外病变的结果，并与 CT、MRI 及骨髓活检结果进行比较。结果：(1) 治疗前23例52处病灶^(18) F-FDG-PET 检出50处，检 出率为96． 2%；其中结内29个检出27个(93． 1%)，结外23个全部检出(100%)。CT 则共检出36个(69． 2%)，其中结内检出26个 (89． 7%)。结外仅检出10个(43． 5%)。^(18) F-FDG-PET 对结内检出敏感性与 CT 类似，而结外敏感性远高于 CT(P＜0． 01) 。(2) 治疗后 22例25个病灶^(18) F-FDG-PET 阴性18处，特异性为72%；CT 为44． 0%，P＞0． 05，两者差别无统计学意义，考虑可能与病例数少有 关。(3) 骨/骨髓受累在45例患者中，40例^(18) F-FDG PET 与骨髓活检结果一致，3例^(18) F-FDG PET 阳性而骨髓活检阴性，行 MRI 检 查，2例阳性，另外2例骨髓活检阳性而^(18) F-FDG PET 阴性。结论：^(18) F-FDG PET 在淋巴瘤的分期和疗效评价中具有较高的敏感和特 异性，有助于准确分期和残余病变性质的鉴别。^(18) F-FDG PET 有一定比率的假阳性和假阴性，因此需与其它检查联合进行以提高病变 检出阳性率和准确性。
Objective： To evaluate fluorine-18^fluorodeoxyglucose positron emission tomography （18^F-FEG PET） in the staging and detecting residual masses of lymphoma. Methods： Forty-five patients with lymphoma before/after treatment were analyzed prospectively. 18^SFFDG PET was compared with computed tomography （CT） ,magnetic resonance imaging （MRI） and bone marrow biopsy （BMB） to investigate lymph node/extranodal manifestations and bone marrow infiltration. Results：Among 23 patients without any treatment, the sensitivities of 18^F-FEG PET and CT were 93. 1% and 89. 7%, respectively（P〉0. 05） in detecting lymph nodes, and 100% and 43.5%, respectively （P〈0. 01） in detecting extranodal manifestations. Among 22 patients after chemotherapy, the specificities of 18^F-FDG PET and CT were 72. 0% and 44. 0%, respectively in detecting residual masses. But there was no significant difference between them, which might be correlated with less cases. 18^F-FDG PET and BMB produced equivalent results in 88. 9 %（40/45） of patients. Another 3 patients were positive by 18^F-FDG PET but negative by BMB. The two of them were confirmed by MRI. Other 2 patients were positive by BMB but negative by 18^F-FEG PET. Bone marrow infiltration of lympboma cells was not found by CT in the present study. Conclusions：18^F-FDG PET is a sensitive and specific technique in the staging and detecting residual masses of lympboma. It is useful to differentiate active tumors from fibrosis and necrosis after treatment. However, 18^F-FEG PET had some false positive and negative findings, suggesting that it should be combined with other diagnostic methods to improve sensitivity and accuracy.
出处
《中国临床医学》
北大核心
2005年第5期856-858,共3页
Chinese Journal of Clinical Medicine
