FDG-PET／CT对弥漫大B细胞淋巴瘤骨髓浸润诊断价值的探讨  

Diagnostic value of FDG-PET/CT in the detection of bone marrow involvement in patients with diffuse large B-cell lymphoma

作　　者：张旭[1] 樊卫[1] 林晓平[1] 梁培炎[1] 张伟光[1] 胡莹莹[1] 

机构地区：[1]中山大学肿瘤防治中心核医学科、华南肿瘤学国家重点实验室,广州510060

出　　处：《中华血液学杂志》2008年第12期832-835,共4页Chinese Journal of Hematology

摘　　要：目的探讨^18氟-氟代脱氧葡萄糖（FDG）-正电子发射断层显缈计算机断层显像（PET／CT）在弥漫大B细胞淋巴瘤（DLBCL）骨髓浸润患者中的诊断价值。方法收集2005年7月至2007年6月我中心81例初诊DLBCL患者资料，所有患者均行FDG-PET／CT及双侧髂骨穿刺活检，部分患者在FDG骨髓代谢活跃灶直接穿刺活检。结果81例初诊DLBCL患者，23例发现FDG骨髓代谢活跃灶，其中17例病理活检证实骨髓浸润；而双侧髂骨穿刺活检11例证实骨髓浸润。对于早期浸润患者，FDG-PET／CT与双侧髂骨骨髓活检的符合率为100％。结论FDG-PET／CT可以全面评价骨髓状况，较双侧髂骨穿刺活检检出更多的骨髓浸润患者；在FDG骨髓代谢活跃灶直接穿刺活检，可提高穿刺检查的准确率。Objective To evaluate the diagnostic value of bone marrow（BM） involvement detected by F-18-flurodeoxyglueose-positron emission tomograpby/computed tomography （18 F-FDG PET/CT） in patients with newly diagnosed diffuse large B-cell lymphoma（DLBCL）. Methods The study population comprised 81consecutive patients with newly diagnosed DLBCL. All patients had both 18F-FDG PET/CT and standard BM biopsy at iliae crest. In 9 patients, additional direct BM biopsy at FDG-avid bone lesion was performed. Results Among all 81 cases, 23 were diagnosed as BM involvement by PET/CT. Of the 23 positive cases 17 were confirmed by biopsy. However, only 11 cases were diagnosed by merely bilateral iliac crest biopsy. In patients in early stage of disease 18 F-FDG PET/CT had the same results as bilateral iliac crest biopsy. Conclusion ^18F-FDG PET/CT is superior to standard BM biopsy in detecting BM involvement in new- ly diagnosed DLBCL patients. In patients with FDG-avid bone lesions, direct PET/CT-guided bone biopsy seems to be more accurate than standard BM biopsy.

关 键 词：^18氟-氟代脱氧葡萄糖-正电子发射计算机断层显像 淋巴瘤 B细胞 肿瘤浸润 活组织检查 

分 类 号：R686[医药卫生—骨科学]