^18F-FDG PET/CT在POEMS综合征诊断中的应用  

^18F-FDG PET/CT imaging in the diagnosis of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes （POEMS） syndrome

作　　者：张冰[1] 赵卫威[2] 王晓燕[1] 陈志丰[1] 饶良俊[1] 史新冲[1] 易畅[1] 张祥松[1] 

机构地区：[1]中山大学附属第一医院PET/CT中心,广州510080 [2]河南省肿瘤医院PET/CT中心

出　　处：《中华核医学与分子影像杂志》2014年第5期345-348,共4页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的 总结多发性周围神经病、脏器肿大、内分泌病变、M蛋白和皮肤病变（POEMS）综合征的18F-FDG PET/CT表现,探讨^18F-FDG PET/CT在该病中的应用价值.方法 2008年10月至2013年2月间经临床证实的11例POEMS综合征患者[男7例,女4例,年龄49～73（58.5±8.4）岁],确诊前均行^18F-FDG PET/CT显像.总结病例的PET/CT图像特征,观察病灶^18F-FDG摄取情况.结果 11例患者均存在多发硬化性骨病变（141个）：顶骨5个,肩胛骨8个,锁骨4个,肋骨16个,椎体64个,髂骨29个,坐骨6个,耻骨8个,肱骨1个;其中58个PET显像阳性,SUVmax为4.3±1.6.肝脏肿大者1例,脾脏肿大者3例,同时存在肝、脾肿大者2例;其中有3例肿大脾脏FDG摄取增高,SUVmax为3.2～4.1.5例患者多发淋巴结肿大,均可见FDG摄取增高,SUVmax为2.6～4.9.胸腔积液者1例,腹腔积液者3例,盆腔积液者3例,三者并存2例,且这2例合并存在皮下水肿,均未见异常^18F-FDG摄取.结论 ^18F-FDG PET/CT可以同时发现POEMS综合征的骨损害、脏器肿大以及血管外水容量过负荷等多系统病变,其表现具有一定的特征性,能为临床进一步诊治提供依据.Objective To analyze the PET/CT findings in polyneuropathy,organomegaly,endocrinopathy,M-protein,and skin changes （POEMS） syndrome and explore its clinical value.Methods Eleven patients with POEMS syndrome （7 males,4 females; age range：49-73 years; mean age：（58.5±8.4） years） from October 2008 to February 2013 were retrospectively analyzed.All patients underwent ^18F-FDG PET/CT scan.The image characteristics,including the abnormal 18 F-FDG uptake and SUVmax of the lesions,were analyzed.Results A total of 141 sclerotic bone lesions were found in 11 cases,including 5 lesions in parietal bones,8 in scapulas,4 in clavicles,16 in ribs,64 in vertebraes,29 in iliac bones,6 in ischiums,8 in pubic bones and 1 in humerus.Fifty-eight lesions had increased FDG uptake with the average SUVmax of 4.3±1.6.One case was with hepatomegaly,3 with splenomegaly,2 with hepatosplenomegaly and 5 with lymphadenopathy.Three patients with splenomegaly and 5 with lymphadenopathy were hypermetabolic,and the SUVmax was 3.2-4.1 and 2.6-4.9,respectively.One case was with bilateral pleural effusions,3 cases with seroperitoneum,3 cases with pelvic effusion and 2 cases with both polyserous effusions and subcutaneous dropsy.Conclusions Multisystem lesions,including bone damage,organomegaly,extravascular volume overload,could be detected by ^18F-FDG PET/CT in the patients with POEMS syndrome.PET/CT is helpful for the diagnosis.

关 键 词：POEMS综合征 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：R816.1[医药卫生—放射医学]