摘要
目的探索骨髓坏死氟-18-脱氧葡萄糖(^(18)F-fluorodeoxyglucose,^(18)F-FDG)正电子发射断层显像/计算机断层显像(positron emission tomography/computed tomography,PET/CT)表现,提高对该病的认识。方法回顾性分析9例磁共振成像(magnetic resonance imaging,MRI)诊断为骨髓坏死患者的PET/CT及临床资料,对照MRI影像,总结病变分布,选择最大病变,分析^(18)F-FDG代谢特点及CT征象。结果患者男6例,女3例,中位年龄28.0岁,均患淋巴瘤。MRI检查髋部6例、胸腰椎2例、膝部1例。6例髂骨病变,内部均为T1加权像(T1-weighted image,T1WI)高信号,T2脂肪抑制像(T2-fat suppressed image,T2FSI)低信号,伴T1WI边缘环状低信号,其中5例内部代谢减低,边缘代谢增高伴骨质硬化;1例密度及代谢未见异常,MRI显示病变狭长。2例脊柱病变T1WI呈等、低信号,T2FSI高信号,其中1例为等代谢,密度稍高;1例代谢减低,密度未见异常。1例股骨病变T1WI高信号,T2FSI低信号,代谢及密度增高。8例PET/CT发现MRI检查范围之外更多病变。8例更早期的PET/CT发现部分病变呈低代谢、等密度。结论^(18)F-FDG代谢减低,后期可伴有边缘线状代谢及密度增高,是骨髓坏死的常见PET/CT影像特点。PET/CT有助于检出骨髓坏死,发现多骨病变。
Objective To explore the fluoro-18-deoxyglucose(^(18)F-FDG)positron emission tomography/computed tomography(PET/CT)features of bone marrow necrosis and improve the understanding of the disease.Methods The PET/CT and clinical data of 9 patients with bone marrow necrosis diagnosed by magnetic resonance imaging(MRI)were retrospectively analyzed.Compared to MRI,the distribution of lesions was summarized.The^(18)F-FDG metabolic and CT features of the selected largest lesion were analyzed.Results There were 6 males and 3 females with a median age of 28.0 years.All patients were diagnosed with lymphoma.MRI scans of the hip,spine and knee were performed in 6,2,and 1 case respectively.The iliac lesions in 6 cases showed internal high signal intensity on T1-weighted images(T1WI),low signal intensity on T2-fat suppressed images(T2FSI),and peripheral linear hypointensity on T1WI.The iliac lesions in 5 cases demonstrated internal decreased ^(18)F-FDG metabolism,peripheral linear increased^(18)F-FDG uptake and density on PET/CT.The iliac lesion in one case did not show abnormal ^(18)F-FDG metabolism and density on PET/CT,the lesion was narrow and long on MRI.The vertebral lesions in two cases showed isointensity to hypointensity on T1WI and hyperintensity on T2FSI.On PET/CT,one vertebral lesion was isometabolic with slightly higher density,the other vertebral lesion showed reduced ^(18)F-FDG metabolism with normal density.One femoral lesion showed high signal intensity on T1WI and low signal intensity on T2FSI,with increased ^(18)F-FDG metabolism and density on PET/CT.PET/CT revealed more lesions beyond the scan range of MRI in 8 cases.In 8 cases,abnormal signs were demonstrated on much earlier PET/CT scans performed at a median time about 13.5(8.25,32.75)months before the MRI scan,but no one complained of any related discomfort at that time.The iliac lesions in 5 cases had decreased ^(18)F-FDG uptake,of which 3 lesions showed peripheral linear high-density,and 2 lesions showed no abnormal density.The iliac lesion in one case did not show abnormal ^(18)F-FDG metabolism and density.One vertebral lesion showed reduced metabolism and isodensity.In the case with knee MRI,the earlier PET/CT showed multiple linear increased ^(18)F-FDG uptake in the bilateral femoral heads and the humerus heads,without abnormal density.During follow up PET/CT scans,the femoral head lesions in 3 cases showed cortical fracture and collapse,the vertebral lesions 2 cases demonstrated multiple Schmorl s nodules or compression fracture.Conclusion Decreased^(18)F-FDG uptake,with probably subsequent peripheral linear increased metabolism and density,is a common PET/CT feature of bone marrow necrosis.PET/CT is helpful to detect bone marrow necrosis and find multiple skeletal lesions.
作者
宋乐
李慧
张卫方
Song Le;Li Hui;Zhang Weifang(Department of Nuclear Medicine,Peking University Third Hospital,Beijing 100191,China)
出处
《首都医科大学学报》
CAS
北大核心
2024年第1期36-41,共6页
Journal of Capital Medical University
基金
北京市临床重点专科建设项目(2022年)。
