^(18)F-FDGPET/CT在儿童神经母细胞瘤诊断分期中的应用  

^(18)F-FDG PET/CT in the Staging of Pediatric Neuroblastoma

作　　者：王剑杰[1] 周鑫[1] 王骁[1] 马潞娜[1] 李立伟[1] 

机构地区：[1]空军总医院核医学科,北京100142

出　　处：《中国医学影像学杂志》2014年第12期936-940,942,共6页Chinese Journal of Medical Imaging

摘　　要：目的探讨18F-FDG PET/CT在儿童神经母细胞瘤诊断分期中的应用价值。资料与方法回顾性分析经手术病理证实的24例神经母细胞瘤患儿的18F-FDG PET/CT表现,观察肿瘤形态、大小、密度及与周围结构的毗邻关系,肿瘤的FDG代谢特征及肿瘤分期。结果 PET/CT显像示多数患儿处于中晚期,表现为全身多部位肿瘤侵犯,包括区域淋巴结、全身骨髓、脑膜、眼眶内或椎管;20例原发病灶位于腹膜后交感神经链走行区或肾上腺,4例位于纵隔内交感神经链走行区。肿瘤FDG代谢程度变异较大,从接近到明显高于肝脏放射性本底不等,最大标准化摄取值为0.8~3.9,肿瘤/肝脏最大标准化摄取值比值为1.6~9.5;16例瘤内可见砂粒样或斑块状钙化。3例肿瘤分期为Ⅲ期,21例Ⅳ期。结论儿童神经母细胞瘤的特征性PET/CT表现为体积常较大、密度混杂合并钙化,易包绕大血管、多合并淋巴结及远处器官转移,可以为儿童神经母细胞瘤的术前诊断和准确分期提供客观的影像学依据。Purpose To investigate the application of 18F-FDG PET/CT in the diagnosis and staging of pediatric neuroblastoma. Materials and Methods PET/CT manifestations of 24 children with neuroblastoma confirmed by pathology were retrospectively analyzed; morphology, size, density, the relationship with the adjacent structures, FDG metabolism characteristics and staging of the tumor were observed. Results PET/CT imaging showed that most patients were at middle or advanced stage, multiple lesions were detected throughout the whole body, including regional lymph nodes, the bone marrow of whole body, menigeals, fossa orbitalis or vertebral cannal. 20 cases of primary lesions located in the retroperitoneal sympathetic nerve chain distribution area or adrenal gland, and 4 located in thoracic mediastinum along the sympathetic nerve chain. FDG PET/CT images showed the tumors had a very wide range in the uptake intensity of FDG, from moderately to highly uptake intensity, the radioactivity range from slightly higher than liver radioactivity background to apparently higher than liver, the maximum SUV was from 0.8 to 3.9, the tumor/liver ratio was from 1.6 to 9.5; sand-like or patchy calcification could be observed within the tumor in 16 cases. 3 cases of tumor were stage Ill, 21 cases were stage IV. Conclusion The relative specific PET/CT manifestation of pediatric neuroblastoma include： large mass with mixed density, calcification within the lesion, often encircle the retroperitoneal large vascular, coinstantaneous metastases either lymph nodes or remote tissue or organ, which can serve as accurate and external medical imaging evidence for both the diagnosis and staging of neuroblastoma before operation.

关 键 词：神经母细胞瘤 体层摄影术 X线计算机 体层摄影术 发射型计算机 单光子 氟脱氧葡萄糖F18 肿瘤分期 儿童 

分 类 号：R739.43[医药卫生—肿瘤] R730.42[医药卫生—临床医学]