摘要
目的探讨18F-氟脱氧葡萄糖(18F-FDG)-正电子发射断层显像/X线计算机体层成像(PET/CT)检测软组织转移瘤的价值。方法搜集2010年8月至2012年5月经我院PET/CT中心诊断软组织转移瘤患者17例完整的影像学及临床资料(均随访)。其中肺癌8例(腺癌7例,鳞癌1例),食管癌2例(鳞癌1例,腺癌1例),胃肠道腺癌5例,子宫内膜癌2例。排除明显淋巴结转移如腋窝及腹股沟淋巴结、骨转移合并软组织肿块、淋巴瘤、恶性黑色素瘤、神经纤维瘤病和原发软组织肉瘤等。结果 17例晚期恶性肿瘤18F-FDG-PET/CT检测出软组织转移灶,其中13例肌肉转移,2例皮下软组织转移,2例肌肉及皮下软组织内均发生转移,肌肉转移发生率为88.2%(15/17),皮下软组织转移发生率为23.5%(4/17)。17例晚期恶性肿瘤18F-FDG-PET/CT共检出转移灶221个,肌肉转移灶51个,约占23.1%(51/221),PET示四肢肌肉、椎旁肌肉、胸腹壁、肩部及盆腔肌肉内49个高代谢结节,左侧翼外肌2个高代谢结节,标准摄取最大值(SUVmax)4.25~8.98。51个病灶CT平扫显示等密度或稍低病灶12个,显示率为23.5%(12/51),病灶最大径均>2.0 cm,部分突向体表。PET/CT显示皮下软组织内170个结节,CT显示170个,最大径0.3~1.2 cm,PET显示82个,SUVmax 1.25~3.52,约占48.2%(82/170)。17例自PET/CT检查之日起,生存期40~160天,平均55.4天。结论 PET/CT对软组织转移瘤敏感性高。肌肉内转移灶PET优于CT,皮下软组织转移灶PET不及CT。软组织转移瘤行PET/CT检查,不仅可以最大程度的检出转移灶,有助于确定最佳的活检部位;还有利于原发癌的显示,有助于全面判断肿瘤分期及预后。
Objective To investigate the value of ^18F-FDG-PET/CT in detecting soft tissue metastases. Methods The complete imaging and clinical data of 17 patients with soft tissue metastases diagnosed by ^18F-FDG-PET/CT were collected from August 2010 - May 2012. The primary malignant tumors included 8 cases of lung cancer （7 cases of adenoeareinoma, 1 case of squamous cell carcinoma）, 2 cases of esophageal carcinoma （1 case of squamous cell carcinoma and 1case of adenocarcinoma）, 5 cases of adenocarcinoma of the GIT and 2 cases of endometrial carcinoma. Excludsive criteria included lymph node metastasis such as axillary and inguinal lymph nodes, bone metastasis invading soft tissues, lympho- ma, malignant melanoma, neurofibromatosis and primary soft tissue sarcoma. Results ^18F-FDG-PET/CT detected 17 ca- ses of advanced malignant lesions including 13 cases of muscle metastases, 2 cases of subcutaneous soft tissue metastases, 2 cases of both muscle and subcutaneous soft tissue metastases. Incidence of muscle metastasis was 88.2% （15/17） while that of subcutaneous soft tissue metastasis was 23.5% （4/17）. Total of 221 metastases were detected by ^18F-FDG-PET/CT including 51 muscle metastases accounting for 23.1% （51/221 ）. PET detected 49 high metabolic nodules in thigh mus- cle, paraspinal muscles, chest wall, shoulder and hip muscles while 2 high metabolic nodules were detected in infraspina- tus muscle, with SUVmax of 4.25 -8.98. CT scan detected 51 lesions in which 12 were isodensity or slightly lower density lesions accounting for 23.5% （ 12/51 ） with a maximum diameter 〉 2.0 cm, some of which are superficial to the skin. PET/CT detected 170 subcutaneous soft tissue nodules while CT detected all 170 nodules with a maximum diameter of 0.3 - 1.2 cm, accounting for 100% （170/170） , but PET detected only 82 nodules with SUVmax 1.25 -3.52, accounting for 48.2% （82/170）. The life time of 17 patients were 40 - 160 days （mean days, 55.4 days） after soft tissue metastasis was diagnosed. Conclusion PET is more sensitive in detecting muscle metastases while CT is more sensitive in detecting subcutaneous soft tissue metastases. In cases of soft tissue metastases, PET/CT can detect metastases along with the prima- ry cancer , which is help to evaluate tumor staging and prognosis.
出处
《临床放射学杂志》
CSCD
北大核心
2014年第2期254-258,共5页
Journal of Clinical Radiology
