摘要
目的探讨18氟-氟代脱氧葡萄糖(18F-FDG)PET-CT在淋巴瘤分期及疗效评价中的临床应用价值。方法回顾分析28例淋巴瘤患者(HL 6例,NHL 22例)在治疗前后进行18F-FDG PET-CT对比检查的结果,并与增强CT及骨髓活检结果进行比较。结果治疗前68处病灶18F-FDG PET-CT检出67个,检出率为98.5%,其中结内37个全部检出(100%),结外31个检出30个(96.8%);增强CT则共检出病灶45个(66.2%),其中结内37个检出32个(86.5%),结外31个仅检出13个(41.9%)。6例(21.4%)的分期得到上调并改变了1例(3.6%)的治疗方案。治疗后32处病灶18F-FDG PET-CT检出29个,检出率为90.6%,其中结内17个检出15个(88.2%),结外15个检出14个(93.3%);增强CT则共检出病灶18个(56.3%),其中结内17个检出13个(76.5%),结外15个仅检出5个(33.3%)。治疗后有2例(7.1%)的分期得到上调,8例(28.6%)下调,改变了8例(21.4%)的治疗方案。18F-FDG PET-CT对淋巴瘤患者治疗前后结内病灶检出率与增强CT相似(P<0.05),而结外病灶检出率则明显高于增强CT(P>0.05)。28例中25例18F-FDG PET-CT与骨髓穿刺结果一致。治疗后18F-FDGPET-CT对复发的阳性预测值93.8%,阴性预测值为83.3%;增强CT的阳性预测值75%,阴性预测值50%。结论18F-FDGPET-CT在淋巴瘤分期及疗效评价中具有重要的临床价值,有助于准确分期和残余病变性质的鉴别。
Objective To evaluatie fluorine - 18 fluorodeoxyglucose PET- CT in staging and detecting residual masses of lymphoma. Methods ^18F- FDG PET- CT imaging was performed in 28 patients with lymphoma（6 HL patients and 22 NHL patients）before and after treatment. The findings of ^18F - FDG PEr - CT images were analyzed qualitatively. ^18F - FDG PEr - CT images were compared with syn- chronous routine images, such as enhancement scan CT and bone marrow biopsy（BMB）. Results Forty - six studies were performed in 28 patients with lymphoma in this study（each study performed before and after treatment）. Without any treatment,the sensitivities of ^18F- FDG PET -CT and enhancement scan CT were 100% and 86.5% ,respectively（ P 〉 0.05） ,in detecting lymph nedes, and 96.8% and 41.9% ,respectively （ P 〈0.05）,in detecting extranodal manifestations, ^18F-FDG PET- CT led to change 21.4% in clinical staging and 3.6% in management. After treatment, the sensitivities of ^18F- FDG PET- CT and enhancement scan CT were 88.2 % and 76.5%, respectively（ P 〉 0.05） ,in detecting lymph nedes, and 93.3% and 33.3% ,respectively （ P 〈 0.05） ,in detecting extranodal manifestations, ^18F- FDG PET- CT led to change 35.7% in clinical staging and 28.6% in management. ^18F - FDG PET - CT and BMB produced equivalent results in 89.3% （25/28） of patients.The positive predictive value and negative predictive value of recurrence detected by ^18F- FDG PET- CT were 93.8% and 83.3%,while those by CT were 75% and 50% after therapy. Conclusions ^18F- FDG PET- CT imaging plays an important role in restaging and detecting residual masses of lymphoma. It is useful for differentiating active tumors from fibrosis and necrosis after treatment.
出处
《武警医学》
CAS
2008年第8期684-687,共4页
Medical Journal of the Chinese People's Armed Police Force
