自身免疫性胰腺炎36例^18F-FDGPET/CT显像特征分析  

Analysis of ^18F-FDG PET/CT imaging characteristics in 36 patients with autoimmune pancreatitis

作　　者：刘莉[1] 张建[2] 贾国荣[2] 余仲飞 刘瑶[2] 程超[2] 杨剑[2] 汪建华[4] 王玉涛[4] 左长京[2] 

机构地区：[1]徐州医学院附属医院核医学科,221006 [2]第二军医大学长海医院核医学科,上海200433 [3]解放军第四一一医院PET/CT中心,上海200081 [4]宁波大学医学院附属医院放射科,315020

出　　处：《中华核医学与分子影像杂志》2016年第3期222-228,共7页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：国家自然科学基金（81170435）;中国博士后基金（20100480545）;上海市科委国际合作基金（10410708800）

摘　　要：目的 探讨^18F-FDG PET/CT在自身免疫性胰腺炎（AIP）中的临床应用价值.方法 回顾性分析2010年8月至2014年3月36例经组织学或临床随访证实的AIP患者（男33例,女3例;平均年龄60岁）的^18F-FDG PET/CT胰腺及全身影像表现,总结其形态、代谢特征,并对32例双时相扫描的早期及延迟SUVmax间差异行配对t检验.结果 （1）根据胰腺病灶受累范围和形态代谢特点,将AIP分为弥漫型（47.2％,17/36）、局灶型（27.8％,10/36）、混合型（19.4％,7/36）和多灶型（5.6％,2/36）.33例（91.7％）表现为胰腺病变区代谢显著增高,SUVmax为5.32± 1.83;另3例轻度摄取,SUVmax为2.13±0.15.32例行双时相显像,早期相SUVmax为5.08±2.03,延迟相SUVmax为6.11±2.68（t=-7.305,P＜0.01）,滞留指数（RI）为（18.0±16.1）％.（2）10例显示鞘膜征,其中2例鞘膜代谢明显高于异常胰腺实质;9例显示主胰管改变.（3）34例（94.4％,34/36）发现胰腺外病灶,主要包括纵隔及肺门淋巴结、唾液腺、颈部或颌下淋巴结等处代谢增高;21例（63.6％,21/33）男性患者发现前列腺呈类“八”字形代谢异常增高灶.（4）全胰腺受累组（弥漫型＋混合型）及胰腺部分受累组（局灶型＋多灶型）胰腺外器官累及例次分别为（4.17±2.15）和（2.64±1.63）例次（t=2.10,P＜0.05）.结论 AIP在^18F-FDG PET/CT上胰腺病灶表现为多样性的代谢增高,延迟相病灶代谢进一步升高.^18F-FDGPET/CT可很好地显示AIP的胰腺外器官受累,有助于AIP的诊断及全身评估.Objective To investigate the imaging characteristics and the clinical value of ^18F-FDG PET/CT imaging in autoimmune pancreatitis （AIP）.Methods The ^18F-FDG PET/CT imaging characteristics of 36 patients （33 males,3 females;average age 60 years） with AIP proved by histopathology or clinical follow-up from August 2010 to March 2014 were retrospectively analyzed.The morphologic and metabolic abnormalities of pancreatic and extra-pancreatic lesions were analyzed.The early SUVmax and delayed SUVmax were compared by paired t test in 32 patients who underwent dual time point ^18F-FDG PET/CT imaging.Results （1） ^18F-FDG PET/CT showed diffuse uptake of FDG by the pancreas in 17 patients （47.2%,17/36）,localized uptake in 10 patients （27.8%,10/36）,mixed uptake in 7 patients （19.4%,7/36）,and multifocal uptake in 2 patients （5.6%,2/36）.A total of 33 patients （91.7%） had intense FDG uptake in the pancreas with SUVmax of 5.32± 1.83,while the others showed mild FDG uptake with SUVmax of 2.13±0.15.Delayed SUVmax was significantly different from early SUVmax（6.11±2.68 vs 5.08±2.03,t=-7.305,P〈0.01） in the 32 patients undergoing delayed scan.The average retention index （RI） in those patients were （18.0± 16.1）%.（2） Capsule-like rim surrounding the pancreas was found in 10 patients and abnormality of the main pancreatic duct was found in 9 patients.（3） Thirty-four （94.4%,34/36） patients had extra-pancreatic lesions,including mediastinal and pulmonary hilar lymph nodes,salivary glands,cervical and submandibular lymph nodes,and foci with the inverted ＂V＂ shaped high FDG uptake in the prostate,which were found in 21 of 33 （63.6%） male patients.（4） The case-times of extra-pancreatic organs involved were 4.17±2.15 in the whole pancreas involved group （diffuse uptake ＋ mixed uptake）,and 2.64± 1.63 in the partial pancreas involved group （localized uptake ＋ multifocal uptake）,which were significantly different （t=2.10,P〈0.05）.Conclusions Various int

关 键 词：自身免疫疾病 胰腺炎 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：R576[医药卫生—消化系统]