10例颅内原发性恶性淋巴瘤^(18)F-FDG PET显像及与MRI比较  

Comparison of ^(18)F-FDG PET imaging and MRI of intracranial primary malignant lymphoma

作　　者：李德鹏[1] 马云川[1] 苏玉盛[1] 张琳瑛[1] 尚建文[1] 

机构地区：[1]首都医科大学宣武医院 PET 中心,北京100053

出　　处：《中华核医学杂志》2007年第5期257-259,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的分析颅内原发性恶性淋巴瘤(IPML)^(18)F-FDG PET显像特征。方法 IPML 10例,胶质母细胞瘤20例,脑转移瘤15例。分析各自的^(18)F-FDG PET 显像,总结 IPML 病灶的分布、代谢特点以及病灶周围组织的^(18)F-FDG 分布,计算并比较各组的肿瘤灶/对侧相应部位(T/CCR)放射性比值和肿瘤灶周围皮质/对侧相应部位皮质(TSC/CCRC)放射性比值。结果 10例 IPML 包括6例单病灶和4例多病灶,单病灶分布于皮质表面,多病灶多分布于脑中线和脑室周围。与对侧相应部位比较,9例病灶呈团块状^(18)F-FDG 摄取明显增高,1例呈环形^(18)F-FDG 浓聚。高代谢灶周围的皮质呈轻度或中度代谢减低;位于基底节和丘脑区域病灶周围未见代谢减低区。与胶质母细胞瘤和脑转移瘤比较,IPML 对^(18)F-FDG 摄取程度高于胶质母细胞瘤(P<0.05),明显高于脑转移瘤(P<0.01)。IPML 病灶周围皮质对^(18)F-FDG 摄取减低程度低于脑转移瘤(P<0.05),明显低于胶质母细胞瘤(P<0.01)。结论 IPML 病灶呈明显代谢增高,对^(18)F-FDG 摄取程度高于胶质母细胞瘤和脑转移瘤,病灶周围皮质对^(18)F-FDG 摄取减低程度低于胶质母细胞瘤和脑转移瘤。Objective The most common encountered intracranial malignant tumors included glioblastomas, metastatic tumors and intracranial primary malignant lymphomas （IPML）. The aim of the study was to comparatively analyze the ^18F-FDG PET manifestations of the three tumors, in particular the image features of IPML. Methods Ten IPML, 20 glioblastomas and 15 cerebral metastases underwent ^18F-FDG PET. The images were analyzed on the basis of lesion location, uptake value and distribution pattern of FDG. Ratios of tumor to contralateral corresponding region （T/CCR） and of cortex surrounding tumor to the contralateral cortex （TSC/CCRC） were measured using ROI method. Results In 10 IPML, there were 6 cases with solitary focus located on the cerebra surface and 4 multiple lesions neighboring to the midline of brain, basal ganglia and thalamus. All lesions presented as intensely hypermetabolic. There was also mild to moderate hypometabolism in the cortex around the lesions, ^18F-FDG uptake in IPML was higher than glioblastomas and cerebral metastases, but the decrease accumulation of ^18F-FDG in the cortex around IPML was less than that of the other two kinds of tumors. Conclusion IPML presented on PET images as solitary or multiple loci with higher hypermetabolic change and less disturbance on ^18F-FDG uptake in nearby cortex than those of glioblastoma and cerebral metastases, which might serve the purpose of differential diagnosis for intracranial tumors.

关 键 词：脑肿瘤 淋巴瘤 非霍奇金氏 体层摄影术 发射型计算机 脱氧葡萄糖 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]