原发鼻咽淋巴瘤与鼻咽癌的18F-FDG PET/CT诊断与鉴别  

Value of 18F-FDG PET/CT examination in the differential diagnosis of primary nasopharyngeal lymphoma and nasopharyngeal carcinoma

作　　者：吕清湖 唐明灯[1] 林端瑜[1] 刘道佳[1] 李生栩[1] 

机构地区：[1]福建省肿瘤医院(福建医科大学附属肿瘤医院)核医学科,福州350014

出　　处：《国际放射医学核医学杂志》2017年第3期166-172,共7页International Journal of Radiation Medicine and Nuclear Medicine

摘　　要：目的 探讨18F-FDG PET/CT在鉴别诊断原发鼻咽淋巴瘤（PNL）与鼻咽癌（NPC）中的价值.方法 回顾性分析经病理证实、检查前未经过肿瘤治疗的33例PNL和71例NPC患者的PET/CT资料,对鼻咽部病变形态、范围、周围浸润、体积、SUVmax及淋巴结浸润或转移情况进行对比分析,另单独选取PNL中的弥漫性大B细胞淋巴瘤（DLBCL）与NPC患者的鼻咽肿块体积、SUVmax进行比较.应用SPSS13.0软件进行独立样本t检验及四格表x2检验.结果 33例PNL患者中20例病变呈弥漫性浸润鼻咽全壁（双侧对称14例、双侧不对称6例）,未完全浸润全壁13例（单侧7例、双侧6例）;71例NPC患者中10例呈弥漫性浸润鼻咽全壁（双侧对称4例、双侧不对称6例）,未完全浸润全壁61例（单侧39例、双侧22例）;PNL、NPC组累及全壁与不全、单侧与双侧、对称与不对称间差异均有统计学意义（x2=23.75、10.38、16.74,均P＜0.001）.PNL、NPC病变患者局限于鼻咽壁者分别有26、17例,累及深部结构者分别有7、54例,两者间差异有统计学意义（x2=27.94,P＜0.001）.PNL、NPC患者中,病变凸入鼻后孔的分别有21、24例,两者之间的差异有统计学意义（x2=8.17,P＜0.05）.PNL、DLBCL和NPC患者鼻咽肿块体积分别为（3.70±5.53）×104、（5.05±6.89）×104、（2.06±2.31）×104 mm3,PNL、DLBCL患者与NPC患者鼻咽肿块体积之间的差异均无统计学意义（t=1.63、1.85,均P＞0.05）.PNL、DLBCL、NPC患者肿块SUVmax分别为12.00±6.34、14.26±6.42、10.09±4.41,PNL患者与NPC患者间差异无统计学意义（t=1.55,P＞0.05）,DLBCL患者与NPC患者间差异有统计学意义（t=2.67,P＜0.05）.PNL患者中26例伴有咽旁或颈部淋巴结浸润,NPC患者中51例伴有咽旁或颈部淋巴结转移,淋巴结SUVmax最大者长径、短径及平均直径间差异均无统计学意义（t=0.79、1.37、2.03、1.71,均P＞0.05）.26例伴有咽旁或颈部淋巴结浸润的PNL患者中3例可见轻�Objective To explore the value of 18F-FDG PET/CT examination in the differential diagnosis of primary nasopharyngeal lymphoma （PNL） and nasopharyngeal carcinoma （NPC）.Methods PET/CT data of 33 patients with PNL and 71 patients with NPC who were confirmed histopathologically and had not undergone oncoth erapy before examination were retrospectively analyzed.The form,range,invasion,volume,SUVmax of nasopharyngeal lesion,and lymphadenopathy involvement were analyzed comparatively.The SUVmax and volume of lesions that confirmed diffuse large B cell lymphoma（DLBCL）were compared with NPC.t-text and x2-text with SPSS 13.0.Results Diffuse infiltration of all nasopharyngeal walls was detected in 20 of 33 patients with PNL（bilateral symmetry in 14 patients and asymmetry in 6） and 10 of 71 patients with NPC（bilateral symmetry in 4 patients and asymmetry in 6）.Partial infiltration of nasopharyngeal walls was observed in 13 of 33 patients with PNL（unilateral invasion in 7 patients and bilateral invasion in 6） and 61 of 71 patients with NPC（unilateral invasion in 39 patients and bilateral invasion in 22）.Statistical significances were found between diffuse and partial infiltration,unilateral and bilateral invasion,and symmetry and asymmetry of nasopharyngeal walls of PNL and NPC（x2=23.75,10.38,and 16.74,respectively;all P〈0.001）.Tumor limited to the nasopharyngeal wall was found in 26 patients with PNL and 17 patients with NPC.Meanwhile,deep-structure invasion was detected in 7 patients with PNL and 54 patients with NPC.Significant difference was found in tumor invasion between PNL and NPC（x2=27.94;P〈0.001）.Tumor volumes of PNL,DLBCL,and NPC were 3.70± 5.53 ×104,5.05±6.89 ×104,and 2.06±2.31 ×104 mm3,respectively.No significant difference was found between tumor volume of PNL and DLBCL compared with NPC（t=1.63 and 1.85 respectively;both P〉0.05）.The SUVmax＇s of PNL and NPC were 12.00 ±6.34,14.26 ±6.42,and 10.09 ±4.41,respectively.No significant difference was found between

关 键 词：鼻咽肿瘤 氟脱氧葡萄糖F18 正电子发射断层显像术 体层摄影术 X线计算 机 鼻咽淋巴瘤 

分 类 号：R730.44[医药卫生—肿瘤] R739.63[医药卫生—临床医学]