^(18)F-FDG-PET/CT对软组织转移瘤的诊断价值  

Diagnostic Value of ^(18)F-FDG-PET/CT in Soft Tissue Metastases

作　　者：邱大胜[1] 胡晓燕[1] 李杰[1] 朱佳[1] 彭辽河[1] 

机构地区：[1]湖北省肿瘤医院PET/CT中心,430079

出　　处：《临床放射学杂志》2014年第2期254-258,共5页Journal of Clinical Radiology

摘　　要：目的探讨18F-氟脱氧葡萄糖(18F-FDG)-正电子发射断层显像/X线计算机体层成像(PET/CT)检测软组织转移瘤的价值。方法搜集2010年8月至2012年5月经我院PET/CT中心诊断软组织转移瘤患者17例完整的影像学及临床资料(均随访)。其中肺癌8例(腺癌7例,鳞癌1例),食管癌2例(鳞癌1例,腺癌1例),胃肠道腺癌5例,子宫内膜癌2例。排除明显淋巴结转移如腋窝及腹股沟淋巴结、骨转移合并软组织肿块、淋巴瘤、恶性黑色素瘤、神经纤维瘤病和原发软组织肉瘤等。结果 17例晚期恶性肿瘤18F-FDG-PET/CT检测出软组织转移灶,其中13例肌肉转移,2例皮下软组织转移,2例肌肉及皮下软组织内均发生转移,肌肉转移发生率为88.2%(15/17),皮下软组织转移发生率为23.5%(4/17)。17例晚期恶性肿瘤18F-FDG-PET/CT共检出转移灶221个,肌肉转移灶51个,约占23.1%(51/221),PET示四肢肌肉、椎旁肌肉、胸腹壁、肩部及盆腔肌肉内49个高代谢结节,左侧翼外肌2个高代谢结节,标准摄取最大值(SUVmax)4.25~8.98。51个病灶CT平扫显示等密度或稍低病灶12个,显示率为23.5%(12/51),病灶最大径均>2.0 cm,部分突向体表。PET/CT显示皮下软组织内170个结节,CT显示170个,最大径0.3~1.2 cm,PET显示82个,SUVmax 1.25~3.52,约占48.2%(82/170)。17例自PET/CT检查之日起,生存期40~160天,平均55.4天。结论 PET/CT对软组织转移瘤敏感性高。肌肉内转移灶PET优于CT,皮下软组织转移灶PET不及CT。软组织转移瘤行PET/CT检查,不仅可以最大程度的检出转移灶,有助于确定最佳的活检部位;还有利于原发癌的显示,有助于全面判断肿瘤分期及预后。Objective To investigate the value of ^18F-FDG-PET/CT in detecting soft tissue metastases. Methods The complete imaging and clinical data of 17 patients with soft tissue metastases diagnosed by ^18F-FDG-PET/CT were collected from August 2010 - May 2012. The primary malignant tumors included 8 cases of lung cancer （7 cases of adenoeareinoma, 1 case of squamous cell carcinoma）, 2 cases of esophageal carcinoma （1 case of squamous cell carcinoma and 1case of adenocarcinoma）, 5 cases of adenocarcinoma of the GIT and 2 cases of endometrial carcinoma. Excludsive criteria included lymph node metastasis such as axillary and inguinal lymph nodes, bone metastasis invading soft tissues, lympho- ma, malignant melanoma, neurofibromatosis and primary soft tissue sarcoma. Results ^18F-FDG-PET/CT detected 17 ca- ses of advanced malignant lesions including 13 cases of muscle metastases, 2 cases of subcutaneous soft tissue metastases, 2 cases of both muscle and subcutaneous soft tissue metastases. Incidence of muscle metastasis was 88.2% （15/17） while that of subcutaneous soft tissue metastasis was 23.5% （4/17）. Total of 221 metastases were detected by ^18F-FDG-PET/CT including 51 muscle metastases accounting for 23.1% （51/221 ）. PET detected 49 high metabolic nodules in thigh mus- cle, paraspinal muscles, chest wall, shoulder and hip muscles while 2 high metabolic nodules were detected in infraspina- tus muscle, with SUVmax of 4.25 -8.98. CT scan detected 51 lesions in which 12 were isodensity or slightly lower density lesions accounting for 23.5% （ 12/51 ） with a maximum diameter 〉 2.0 cm, some of which are superficial to the skin. PET/CT detected 170 subcutaneous soft tissue nodules while CT detected all 170 nodules with a maximum diameter of 0.3 - 1.2 cm, accounting for 100% （170/170） , but PET detected only 82 nodules with SUVmax 1.25 -3.52, accounting for 48.2% （82/170）. The life time of 17 patients were 40 - 160 days （mean days, 55.4 days） after soft tissue metastasis was diagnosed. Conc

关 键 词：恶性肿瘤 转移 软组织 正电子发射断层显像 X线计算机体层成像 18-氟脱氧葡萄糖 

分 类 号：R730.44[医药卫生—肿瘤] R738.6[医药卫生—临床医学]