骨骼肌转移瘤的PET-CT诊断价值  

Diagnostic value of PET-CT in skeletal muscle metastases

作　　者：林琳[1] 李勇[1] 王丽范[1] 王家富[1] 韩巍[1] 闫志钧[1] LIN Lin LI Yong WANG Li-f an et al(First Affiliated Hospital of Harbin Medical University, Harbin 150001 ,China)

机构地区：[1]哈尔滨医科大学附属第一医院PET-CT室,黑龙江哈尔滨150001

出　　处：《中国实验诊断学》2017年第9期1491-1495,共5页Chinese Journal of Laboratory Diagnosis

基　　金：黑龙江省教育厅科学技术研究项目(12541355)

摘　　要：目的通过对骨骼肌转移瘤(SMM)PET-CT影像特点及临床表现的分析,探讨18 F-FDG PET-CT对于恶性肿瘤骨骼肌转移的诊断价值。方法回顾性分析77例肌肉病变患者,病理及临床确诊为SMM患者53例。对CT及PET-CT影像的诊断结果与病理结果相比较,获得相应的病灶检出率、灵敏度、特异性和诊断符合率。另外收集SMM患者基本信息,临床表现,病灶数目、位置、大小、影像学分类、CT值和SUV值。并对结果进行统计学分析。结果53例患者共发现SMM病灶101个,可以来自多种原发恶性肿瘤,其中肺癌最常出现,占32.1%。5例患者诊断为多中心肿瘤。SMM的症状主要表现为疼痛,仅有56.6%的患者会伴随明显症状,因此很多病灶并不容易发现。SMM可发生于全身各处的肌肉内,最易出现在臀部,比例为24.8%,以肿块的形式存在的病灶最多见,密度可以低于或等于正常肌肉组织。SMM对于18 F-FDG均有不同程度的代谢。PET-CT对于肌肉病灶检出率为100%,高于CT检出率50.6%;PET-CT对SMM的灵敏度可达100%,明显高于CT灵敏度58.4%;诊断符合率PET-CT与CT比较具有较大优势,PET-CT符合率为84.4%,CT为72.5%。结论通过对肌肉内转移性病灶的诊断及定位,18 F-FDG PET-CT对于患者分期、再分期、治疗方案的提高及病理取材的精确性均有明显的价值。Objective To evaluate the diagnostic value of lSF-FDG PET-CT in skeletal muscle metastasis（SMM） of malignant tumor by analyzing the characteristics and clinical manifestations of SMM PET-CT images. Methods Retrospective analysis of 77 patients with muscle lesions,pathology and clinical diagnosis of SMM patients in 53 cases. The diagnostic results of CT and PET-CT images were compared with the pathological results, and the corresponding detection rate, sensitivity, specificity and diagnostic coincidence rate were obtained. In addition, the basic information, clinical manifestations,number of lesions,location, size,imaging classification,CT value and SUV value of SMM patients were collected. And the results were analyzed statistically. Results A total of 101 lesions were found in 53 patients. Lesions can come from a variety of primary malignant tumors,of which the most common lung cancer, accounting for 32.1%. Five patients were diagnosed with multiple primary tumors. SMM are mainly symptoms of pain,only 56.6 % of patients will be accompanied by obvious symptoms,so many lesions are not easy to find. SMM can occur in the muscles around the body,and are most likely to appear in the buttocks, accounting for 24.8 % of all lesions. SMM appears in the form of mass,the density can be lower than or equal to the normal muscle tissue. SMM has a different degree of metabolism for 18 F-FDG. PET-CT detection rate of muscle lesions was 100 %, higher than CT detection rate of 50.6 % ; PET-CT on SMM sensitivity of up to 100 %, significantly higher than the CT sensitivity of 58.4 %;the coincidence rate of PET-CT was 84.4% and that of CT was 72.50/oo. Conclusion Due to the ability of 18^F-FDG PET-CT to screen,it is possible to detect abnormal metastatic sites in tumor patients. PET-CT has obvious help in determining staging and treatment regi- men improve the detection rate of SMM in patients with malignant tumors. While helping to guide the biopsy position.

关 键 词：恶性肿瘤 骨骼肌转移 PET-CT 

分 类 号：R730.44[医药卫生—肿瘤] R738[医药卫生—临床医学]