下肢长骨骨肉瘤术前PET/CT与CT对照研究  

A comparison between preoperative PET/CT and CT images of long bone osteosarcoma of the lower extremity

作　　者：白楚杰[1] 朱荣[2] 方志伟[1] 李丽琴 李艳[4] 陈静[1] 李舒[1] 

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所骨与软组织肿瘤科,恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [2]上海市松江区中心医院骨科,上海201600 [3]解放军第二炮兵总医院肿瘤放射诊疗中心,北京100086 [4]美国佐治亚大学生物信息教研室,左治亚州雅典市30602

出　　处：《第二军医大学学报》2013年第1期100-103,共4页Academic Journal of Second Military Medical University

摘　　要：目的对比分析下肢长骨骨肉瘤的PET/CT及CT影像,探讨PET/CT和CT对骨肉瘤远近转移灶的检出情况和两种检查对临床分期的诊断价值。方法收集入组经穿刺活检证实的下肢长骨骨肉瘤患者14例,均行术前全身平扫CT和PET/CT检查,并对肿瘤影像特点、髓腔及肺转移灶影像进行分析。结果原发病灶的平均最大标准化摄取值(SUVmax)是10.68(3.7～21.1),PET/CT发现有转移组患者SUVmax平均值高于无转移组患者(11.94vs 8.01,P<0.05)。PET/CT发现髓腔转移6例8处,相应的CT检查只发现2例2处;PET/CT发现肺转移3例,而相应的CT检查发现肺转移2例。PET/CT对骨髓腔内转移灶的敏感性高于CT检查(P=0.088 67<0.1),而对于肺转移灶的检出率二者差异无统计学意义。PET/CT与CT影像相比,使4例患者的TNM分期有所增加,二者差异有统计学意义(P<0.05)。结论相比于CT检查,PET/CT可以更好地显示骨肉瘤肿瘤范围,对肿瘤的分期诊断较为准确,易于检出髓腔内转移灶,SUVmax值可能有利于评判患者预后。Objective To compare the PET/CT and CT images of lower extremity long bone osteosarcoma, and to explore their performance in detecting distant/local metastases of osteosarcoma and in clinical staging of the lesions. Methods Fourteen patients with biopsy-confirmed lower extremity long bone osteosarcoma were enrolled in the present study. All patients underwent CT and PET/CT examination before operation. The image characteristic of tumors and bone marrow, lung metastases loci were analyzed. Results The mean maximum standard uptake value （SUVmax） of the primary lesions in this group was 10.68 （ranging 3.7-21.1）. PET/CT found that the mean SUVmax value in metastasis group was significantly higher than that in non-metastasis group （11.94 vs 8.01, P〈0.05）. PET/CT also found 6 cases of bone marrow cavity metastases, and CT only found 2 cases. PET/CT detected 3 cases of lung metastases, and CT only found 2 cases. The accuracy of PET/CT in detecting the bone marrow metastases of osteosarcoma was significantly higher than that of CT （P=0.088 67〈0.1）. PET/CT showed no significant difference in detecting lung metastases compared with CT. Compared with CT, PET/CT increased the TNM stage of 4 patients （P〈0.05）. Conclusion Compared with CT, PET/CT has a better performance in demonstrating the tumor involvement, in detecting bone marrow metastasis of osteosarcoma, and in tumor staging. The SUVmax value can help to predict the prognosis of patients with osteosarcoma.

关 键 词：骨肉瘤 正电子发射断层显像术 X线计算机体层摄影术 

分 类 号：R738.1[医药卫生—肿瘤]