18氟-脱氧葡萄糖PET／CT在原发性中枢神经系统淋巴瘤中的诊断价值  

Value of 18 F-FDG PET/CT in the Diagnosis of Primary Central Nervous System Lymphoma

作　　者：潘博[1] 汪世存[1] 方雷[1] 展凤麟[1] 谢强[1] 谢吉奎[1] 李九林[1] 沈赛娟[1] 杨吉刚[2] 

机构地区：[1]安徽省立医院PET／CT中心,安徽省合肥市230001 [2]首都医科大学附属北京友谊医院核医学科,北京100050

出　　处：《医学临床研究》2011年第4期593-596,共4页Journal of Clinical Research

基　　金：[基金项目]2010年度李桓英医学基金会资助课题（10J-L03）,2011年北京市自然科学基金（7112035）

摘　　要：【目的】探讨原发性中枢神经系统淋巴瘤（PCNSL）的18氟一氟代脱氧葡萄糖（18F-fluorodeoxyglucose，18F-FDG）PET／CT图像特点。【方法】回顾性分析11例经手术或穿刺病理证实的PCNSL患者的”F-FDGPET／CT表现。【结果】11例均为弥漫大B细胞型非霍奇金淋巴瘤，单发7例、多发4例，共16个病灶，其中大脑半球11个，基底节2个，右背侧丘脑1个，累及胼胝体并跨越中线1例，左侧小脑半球1例。瘤周1级水肿6例，2级水肿3例，3级水肿2例（3个病灶），1例无明显水肿。所有病灶均为高摄取，标准摄取值（SUV）最大值为21．6，较对侧脑组织SUV明显增高，靶和非靶比值（T／NT）最大值3．72，经单因素方差分析具有显著性（P≤0．01）。【结论]PCNSL18F-PET／CT表现有一定特征，对临床有提示性诊断，尤其全身PET／CT显像阴性而脑实质内单发或多发异常高代谢灶并T／NT〉1．5时，诊断价值更大，同时也为肿瘤活性区脑立体定位穿刺提供了精确部位，提高了活栓的成功率，避免了不必要的外科手术。[Objective] To explore the characteristics of 18 F-PET/CT imaging of central nervous system lymphoma （PCNSL）. [Methods] The manifestations of 18 FDG-PET/CT imaging of 11 cases confirmed as PCNSL by pathology or surgery were analyzed retrospectively. [Results] All 11 cases were diffuse large Bcell now Hodgkin＇s lymphoma, in which 7 cases were unifocal and 4 cases were mukifocal. Among 16 lesions, there were 11 lesions in cerebral hemisphere, 2 in basal ganglia, 1 in right dorsal thalamus, 1 involved in midline corpus callosum and 1 in left cerebellum. Peritumoral ede- ma grade I was found in 6 cases, grade Ⅱ in 5 cases and grade Ⅲ in 2 cases. No obvious edema was found in 1 case. All lesions were high uptake. The maximum of standard uptake value（SUV） max was 21.6 which was significantly higher than that of contralateral normal brain tissue. The maximum of target/nowtarget（T/NT） was 3.72. Chi-square analysis showed that there was statistical significance（ P ≤0.01）. [Conclusion] The manifestation of 18 F-PET/CT of PCNSL has certain characteristics, which may prompt the clinical diagnosis. Especially when the whole PET / CT imaging is nega- tive, and there is single or multiple abnormal foci with high metabolism in brain parenchyma, and T/NT is over 1.5, its diagnostic value is greater. Meanwhile it can provide a precise biopsy site for the puncture of braiwtumor active areas, and increase the success rate of biopsy, and avoid unnecessary surgery.

关 键 词：淋巴瘤/放射摄影术 中枢神经系统肿瘤/放射摄影术 体层摄影术 发射型计算机 

分 类 号：R739.4[医药卫生—肿瘤]