PET/CT在骨巨细胞瘤诊断中的应用  

PET/CT in the diagnosis of giant cell tumor

作　　者：沈智辉 徐白萱[1] 关志伟[1] 雷继晓[1] 杨辉[1] 徐晓丹[1] 刘亚超[1] 

机构地区：[1]中国人民解放军总医院,北京100853

出　　处：《中国临床医学影像杂志》2017年第6期438-441,共4页Journal of China Clinic Medical Imaging

摘　　要：目的:分析^(18)F-FDG PET/CT在骨巨细胞瘤(Giant cell tumor,GCT)中的诊断价值及其在PET/CT中的表现特点。方法:回顾分析解放军总医院骨科11例经病理证实GCT患者的PET/CT影像及临床资料,总结PET/CT在该病中的影像学特点及其优势。结果:11例GCT患者中,发生部位分别为:颈椎3例,胸椎2例,腰椎2例,四肢长骨4例,其中2例术后复发,2例转移。11例GCT患者的PET/CT影像学表现为:11例GCT患者均伴有不同程度的FDG摄取异常增高,SUVmax平均值为10.15±4.42。同机CT以溶骨性骨质破坏为主11例,其中3例可见钙化及骨硬化影存在,膨胀性溶骨性骨质破坏8例,偏心性生长7例,侵犯周围软组织6例,伴有动脉瘤样骨囊肿2例。11例GCT患者中,病理分级Ⅰ级4例,SUVmax平均值为7.73±3.15;Ⅱ/Ⅲ级7例,SUVmax平均值为12.17±4.45。结论:全身^(18)F-FDG PET/CT显像在GCT诊断中起着重要的作用,且GCT患者PET/CT具有一定的特征性表现,有助于早期发现转移,排除恶性疾病,指导临床决策。Objective： To analyze the diagnostic value of ^18F-FDG PET/CT in giant cell tumor（GCT）. Methods： We retrospectively analyzed the clinical data and PET/CT images of 11 cases of GCT patients confirmed by pathology from orthopaedic department of the PLA general hospital. Characteristics and advantages of PET/CT in the diagnosis of GCT were summarized. Results： Among these 11 cases of GCT, the giant cell tumors occured at different sites： 3 cases in cervical vertebra, 2 cases in thoracic and lumbar vertebra and 4 cases in limbs long bone. There were 2 cases of postoperative recurrence and 2 cases of metastasis. The characteristics of PET/CT imaging of the 11 cases of GCT were as the following： 11 cases of GCT had various degrees of FDG uptake, with the average SUVmax of 10.15±4.42. All of the 11 cases of GCT showed osteolytic bone destruction in transverse CT images, including 3 cases with calcification and bone sclerosis, 8 cases with expansive growth, 7 cases with eccentric expansion, 6 cases with soft tissue mass, 2 cases with neurysmal bone cyst. According to the pathology classification, there were 4 cases of grade Ⅰ , with an average SUVmax of 7.73±3.15 and 7 cases of grade Ⅱ/Ⅲ, with an aerage SUVmax of 12.17±4.45. Conclusion： Whole body ^18F-FDG PET/CT performs an important role in the diagnosis of GCT. The characteristic manifestations of GCT in ^18F-FDG PET/CT can help in early detection of metastasis and exclusion of malignant diseases, so that to guide clinical management of GCT.

关 键 词：巨细胞瘤 骨 正电子发射断层显像术 体层摄影术 X线计算机 

分 类 号：R738.41[医药卫生—肿瘤] R817.4[医药卫生—临床医学]