^18F-FDG符合线路显像在胸腺上皮肿瘤诊断中的应用价值  

Diagnostic value of ^18F-FDG coincidence imaging in thymic epithelial tumors

作　　者：刘进军[1] 李琛[1] 王火强[1] 

机构地区：[1]同济大学附属上海市肺科医院核医学科,200433

出　　处：《中华核医学杂志》2009年第4期242-245,共4页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨^18F-脱氧葡萄糖（FDG）符合线路显像在胸腺上皮肿瘤（TET）诊断中的价值。方法回顾性分析37例TET患者的^18F—FDG符合线路显像结果，图像分析采用视觉分析及半定量方法[肿瘤／正常肺组织放射性比值（TLR）]。按WHO TET病理学分类结果将患者分成3组（高生存率组，包括A、AB、B1型；中生存率组，包括B2、B3型；低生存率组，包括胸腺癌）；同时将^18F—FDG显像结果与增强CT影像进行对比，TLR与免疫组织化学检查所测Ki67标记指数（细胞增殖指标）进行相关性分析。组间TLR比较采用方差分析。结果（1）^18F—FDG符合线路显像阳性率91．9％（34／37）；（2）3个不同生存率组TLR间差异有统计学意义（高、中、低生存率组TLR依次为：1．42±0．27，2．13±0．74，3．00±1．19，F=9．99，P〈0．05）；（3）TLR与Ki67标记指数有明显相关性（r=0．613，P=0．002）；（4）^18F-FDG显像发现2例增强CT未发现的病灶，病灶分别位于前胸壁和右锁骨上淋巴结；（5）共有4例伴发重症肌无力。结论^18F—FDG符合线路显像有助于WHO TET病理学分类和发现更多的TET侵犯、转移灶；可以用^18F—FDG在TET的浓聚程度反映细胞的增殖活力。Objective Thymic epithelial tumors（TET） consist of thymoma and thymic carcinoma. The purpose of this study was to investigate the diagnostic value of ^18F-fluorodeoxyglucose （FDG） coincidence SPECT imaging in TET. Methods ^18F-FDG coincidence SPECT images of 37 TET patients （ male 16, female 21, age range 24-82 years; mean age 55 years） were retrospectively analyzed according to the simplified WHO histological classification： high survival thymoma （types A, AB and B1 ）, median survival thymoma （types B2 and B3）, and low survival thymoma （thymic carcinoma）. Qualitative visual interpretation was based on foci of ^18F-FDG uptake＇higher than that of normal mediastinum. Tumour/lung radioactivity ratio （TLR） was calculated from the counts of region of interest （ROI） drawn around the mass and over a comparable area of normal lung tissue in TET patients. The distribution of ^18F-FDG uptake was compared with the enhanced CT findings. TLR was also correlated with the Ki67-1abeling index. Statistical comparison for TLR in different groups were performed with variance analysis. Results Thirty-four TET were positive and 3 negative （A, A, AB） by ^18F-FDG coincidence SPECT images. The differences among the 3 subgroups were statistically significant （ F = 9. 99, P 〈 0.05 ）. The TLR of these 3 subgroups was variable ： 1.42 ±0.27, 2.13 ± 0.74, 3.00 ± 1.19, respectively. A close correlation （ r = 0. 613, P = 0. 002） of the TLR with the Ki67 labeling index （n = 22） was found. In addition, ^18F-FDG coincidence SPECT detected two metastases （anterior chest wall and right supraclavicular fossa lymph node） that were not identified on enhanced CT. Conclusions ^18F-FDG coincidence SPECT is useful in differentiating subgroups of thymic epithelial tumors and in identifying more invasive thymic lesions. ISF-FDG may be a novel tracer that enables in vivo evaluation of cellular proliferation in human TET.

关 键 词：胸腺肿瘤 符合线路 体层摄影术 发射型计算机 单光子 脱氧葡萄糖 

分 类 号：R686[医药卫生—骨科学]