IgG4相关性疾病的^(18)F-FDG PET/CT全身显像  

IgG4 related diseases:whole-body ^(18)F-FDG PET/CT findings

作　　者：冯菲[1] 余仲飞[2] 张建[1] 杨剑[1] 胡胜平[1] 孙高峰[1] 程超[1] 董爱生[1] 孔令山[1] 左长京[1] 

机构地区：[1]第二军医大学长海医院核医学科,上海200433 [2]第二军医大学长海医院放射科,上海200433

出　　处：《医学影像学杂志》2014年第10期1712-1715,共4页Journal of Medical Imaging

基　　金：国家自然基金(81170435);中国博士后基金(20100480545);上海市科委国际合作基金(10410708800);上海市卫生局项目(XBR2011040)

摘　　要：目的分析IgG4相关性疾病(IgG4related disease,IgG4RD)全身PET/CT表现特点,提高对该病的认识及诊断,指导临床诊治。方法回顾性分析14例IgG4相关性疾病患者(男性12例,女性2例,年龄43~75岁,中位年龄59岁的18F-FDG全身PET/CT图像资料,分析受累脏器的形态、密度和18 F-FDG葡萄糖代谢改变。结果 14例患者血清IgG4水平均增高,(970.14±950.70)mg/dl(136~3690mg/dl),18 F-FDG全身PET/CT显像显示IgG4RD患者多个脏器受累:12例(85.7%)胰腺受累,表现为胰腺弥漫性或阶段性肿大,FDG摄取增高;9例(62.3%)唾液腺受累,表现为单侧或双侧唾液腺饱满、肿大,FDG摄取增高;6例(42.9%)胆管系统受累,表现为肝内外胆管轻度扩张,管壁轻度增厚,沿胆管FDG索条样摄取增高;12例男性患者中7例(58.3%)前列腺受累,表现为前列腺单侧叶或双侧叶FDG摄取增高;另还可见甲状腺(5例)、肺部(4例)、肠道(4例)、大动脉(2例)、肾脏(1例)受累改变。结论 IgG4RD是一种全身性、系统性的疾病,18F-FDG PET/CT很好地显示了IgG4RD全身器官受累的形态和代谢改变,有利于IgG4RD的诊断和全身评估。Objective To analyze the PET/CT imaging characteristics of IgG4 related diseases （IgG4 related diseases , IgG4RD） and to investigate the function of 18 F-FDG PET/CT in diagnosing of IgG4RD and whole-body evaluation .Meth-ods Whole-body 18 F-FDG PET /CT findings in 14 patients （male 12 ,female 2 ,age from 43 to 75 ,the median age of 59 years old） with clinical conformed IgG4RD were reviewed retrospectively .Organs＇morphology changes ,density alter and 18 F-FDG metabolism were observed .Results All of 14 cases had a high level of serum IgG4 ,（970 .14 ± 950 .70） mg/dl （136-3690） mg/dl .18 F-FDG PET/CT imaging showed that there were multiple organ involvement in IgG4RD and 12 ca-ses （85 .7% ） with pancreas involvement ,which were characterized by diffuse or segmental enlargement of the pancreas with increased 18 F-FDG uptake;9 cases （62 .3% ） with salivary gland involvement were characterized by unilateral or bilat-eral salivary glands swelling with increased 18 F-FDG uptake;6 cases （42 .9% ） had bile duct system involved ,which were characterized by mild expansion of bile ducts with mild thickening wall .Along the bile duct ,18 F-FDG uptake was in-creased;7 in 12 male patients （58 .3% ） had prostatic involved characterized by unilateral or bilateral lobe with increased 18 F-FDG uptake;Other organs were involved ,including thyroid （5 cases） ,lung （4 cases） ,intestine （4 cases） ,artery （2 cases） and kidney （1 case） .Conclusion IgG4RD is a systemic disease .18 F-FDG PET/CT shows well the changes and metabolic characteristics of organs ,which are involved in IgG4RD .It plays a distinct role in diagnosis of IgG4RD and w hole-body evaluation .

关 键 词：IGG4相关性疾病 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：R593.3[医药卫生—内科学] R814.42[医药卫生—临床医学]