^18F-FDG PET／CT在自然杀伤／T细胞淋巴瘤显像诊断及分期中的应用  

The value of ^18F-FDG PET/CT on the detection and staging of natural killer/T cell lymphomas

作　　者：吴湖炳[1] 王全师[1] 王明芳[1] 李洪生[1] 周文兰[1] 叶香华[1] 王巧愚[1] 

机构地区：[1]南方医科大学南方医院PET中心,广州510515

出　　处：《中华核医学杂志》2010年第1期19-22,共4页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨^18F-脱氧葡萄糖（FDG）PET／CT在自然杀伤（NK）／T细胞淋巴瘤的病灶检测及分期中的价值。方法13例初诊和2例复发NK／T细胞淋巴瘤患者行全身^18F-FDGPET／CT显像。病灶处出现^18F-FDG异常浓聚为阳性。^18F-FDG摄取采用最大标准摄取值（SUVmax）进行定量。所有受检者随访时间均〉6个月。统计学比较用t检验。结果（1）15例NK／T细胞淋巴瘤患者^18F-FDG PET／CT显像均为阳性。11例鼻型患者中，10例PET／CT于鼻腔或鼻咽部探测到肿瘤病灶，且6例突出鼻腔外侵及鼻旁周围组织，7例PET／CT显像于鼻腔外发现1处或多处淋巴瘤受侵病灶。4例非鼻型患者，PET／CT于鼻腔外发现多部位肿瘤侵犯。鼻内、鼻外病灶的SUVmax分别为12．42±9．25和9．54±7．12，两者差异无统计学意义（t=1．120，P〉0．05）。（2）15例中有2例显像前不明原因发热者在PET／CT引导下行病理检查，明确诊断。13例诊断已明确者，7例PET／CT发现更多淋巴瘤病灶，6例因PET／CT检查改变分期。Ⅰ～Ⅱ期患者的SUVmax；稍低于Ⅲ～Ⅳ期者，分别为8．44±5．56和10．32±7．80，但差异无统计学意义（t=0．757，P〉0．05）。结论NK／T细胞淋巴瘤病灶呈^18F-FDG高摄取；在其病灶检测和分期方面，PET／CT显像有优势。Objective ^18F- To investigate the value of -fluorodeoxyglucose （FDG） PET/CT on the detection and staging of natural killer （NK）/T cell lymphomas. Methods Thirteen new and 2 recurrent eases of NK/T cell lymphoma were included in this study and they all underwent whole-body ^18F-FDG PET/ CT scans. A lesion with intense ^18F-FDG uptake was taken as positive for disease involvement and semiquantitative metabolic assessment was performed with the maximum standardized uptake value （SUVmax）. All patients were followed for more than 6 months. The t-test was used to analyze the semi-quantitative data statistics. Results （1） ^18F-FDG PET/CT had 100% positive detection rate for NK/T cell lymphoma. Of 11 eases with disease involvement of the nasal region, PET/CT detected 10, either in the nasal cavity or in the nasopharynx, 6 with extra-nasal infiltration, and 7 with regional nodal metastasis. There were 4 non-nasal cases and PET/CT detected one or multiple extra-nasal lymphoma lesions. The SUVmax of nasal and extra-nasal lesions was 12.42 ± 9.25, 9.54 ± 7. 12, respectively, with no significant difference （ t = 1. 120, P 〉 0. 05 ）. （2） Two cases （2/15） diagnosed of this disease by PET/CT were initially referred as investigation of fever of unknown origin. For the remaining 13/15 known cases, PET/CT detected more ＂unsuspected＂ lymphoma lesions in 7 cases and affected the staging in 6 patients. The ^18F-FDG uptake （ SUVmax ） of Ⅰ - Ⅱ stage patients was mildly lower than that of Ⅲ- Ⅳ stage patients, but no significant difference was observed （ t = 0. 757, P 〉 0.05 ）. Conclusions NK/T cell lymphoma is an intensely ^18F-FDG-avid tumor. ^18 F-FDG PET/CT is an effective imaging tool for detection and staging of this disease.

关 键 词：淋巴瘤 非霍奇金氏 体层摄影术 发射型计算机 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R730.44[医药卫生—肿瘤]