^(18)F-FDG PET/CT对周围神经癌性病理性疼痛的诊断价值观察  

Diagnostic value of ^(18)F-FDG PET/CT for cancer pain of peripheral nerves

作　　者：方雷[1] 安建平[1] 赵辉[1] 徐晓红[1] 毛俊锋[1] 李运[1] 戴伟[1] 

机构地区：[1]兰州军区兰州总医院核医学科,兰州730050

出　　处：《解放军医学杂志》2013年第11期909-912,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的观察周围神经癌性病理性疼痛的18F-脱氧葡萄糖(FDG)PET/CT影像特征,探讨18F-FDG PET/CT对周围神经癌性病理性疼痛的诊断价值。方法回顾性分析经病理检查或长期随访证实的10例周围神经癌性病理性疼痛患者18F-FDG PET/CT影像学资料,比较患者受累周围神经与健侧周围神经PET/CT表现的异同,采用SPSS 17.0软件对受累的周围神经及健侧对应部位周围神经的最大标准化摄取值(SUVmax)行配对t检验。结果 10例周围神经癌性病理性疼痛患者共发现病灶17个,PET示病灶均沿神经丛、神经束或椎间孔走行,且表现为束条形、根须状或结节状FDG代谢异常增高影,SUVmax为6.67±3.24,同机CT病灶表现为沿神经束或神经根管走行的束条形、根须状或结节状软组织密度影,病灶与周围软组织及邻近脂肪间隙分界不清;健侧对应部位周围神经在18F-FDG PET及同机CT上均未见明确显影,其SUVmax为1.19±0.48。癌性神经病理性疼痛受累周围神经与健侧周围神经SUVmax比较,差异有统计学意义(t=9.389,P<0.001)。结论 18F-FDG PET/CT可以准确反映肿瘤对周围神经的侵犯及转移,显示病灶的大小、形态、分布及肿瘤活性,对周围神经癌性病理性疼痛的诊断具有重要价值。Objective To observe the characteristics of cancer pain of the peripheral nerves on ^18F-FDG PET/CT images, and explore the diagnostic value of ^18F-FDG PET/CT for cancer pain of the peripheral nerves. Methods Imaging data of ^18F-FDG PET/CT of 10 patients with cancer pain of the peripheral nerves confirmed by histopathology or long-term follow-up were analyzed retrospectively. The similarities and differences in PET/CT manifestations between the diseased side peripheral nerves and contralateral normal peripheral nerves were observed, and the maximum standardized uptake values （SUVmax） were compared by paired t test with SPSS 17.0 software. Results Seventeen secondary malignant peripheral nerve lesions were found in 10 cases. On PET images, the lesions were found to spread along the plexus, nerve bundle or intervertebral foramen, and manifested as bundle-, root-hair-or nodule-like high ^18F-FDG metabolic tissue, with the SUVmax as high as 6.67 ± 3.24. The lesions on CT images manifested as bundle-, root-hair- or nodule-like soft tissue density shadows spreading along the nerve bundle or nerve root canal, and there was no clear border between the lesions and the surrounding soft and fat tissues. The contralateral normal peripheral nerves showed no abnormal images on ^18F-FDG PET or CT, and the SUVmax was 1.19 ± 0.48, which was significantly different from that of nerves on disease side （t=9.389, P〈0.001）. Conclusion ISF-FDG PET/CT can accurately show invasion and metastasis to the peripheral nerve of tumor, and it also can display the size, shape, distribution and tumor activity of the lesions, thus it is valuable for the diagnosis of cancer pain of the peripheral nerves.

关 键 词：肿瘤转移 神经病理性疼痛 体层摄影术 x线计算机 正电子发射断层显像术 氟脱氧葡萄糖F18 

分 类 号：R730.44[医药卫生—肿瘤]