^18F-FDG PET/CT对肝细胞肝癌骨转移特征初步研究  

^(18)F-FDG PET/CT characteristics of bone metastases from hepatocellular carcinoma

作　　者：王志忠[1] 苏家贵[1] 欧阳晓辉[1] 周晓红[1] 刘晓飞[1] 何宝明[1] 

机构地区：[1]中国人民解放军第309医院核医学科,北京100091

出　　处：《医学影像学杂志》2017年第12期2322-2325,共4页Journal of Medical Imaging

摘　　要：目的应用^(18)F-FDG PET/CT研究肝细胞肝癌骨转移病灶的形态及代谢特征。方法回顾研究45例肝细胞肝癌患者的191个骨转移病灶的^(18)F-FDG PET/CT影像学结果。应用目测法和半定量分析法对每个病灶分析,研究骨转移病灶的形态及代谢特征。通过病理和影像学方法对骨转移病灶进行确诊。所有数据经过统计学处理。结果 45例具有骨转移的患者中,21例骨转移病灶出现软组织影;191个病灶分布以脊椎、肋骨、骨盆最常见;143个病灶表现溶骨性改变,48个病灶未见明确的骨质破坏,仅仅表现为局灶性FDG浓聚。其中2处骨转移病灶仅表现出溶骨性改变,无异常FDG摄取。所有骨转移病灶中,64个伴有软组织形成,有软组织形成和无软组织影生产的骨转移病灶组的最大SUV值分别为6.56±3.64和5.35±2.41,P=0.034,两组间具有显著性的差异。^(18)F-FDGPET/CT能发现所有的病灶中,单纯的FDG-PET能探测到98%(186/191)病灶,单纯的CT探测到87%(167/191)病灶。结论肝细胞肝癌的骨转移病灶以溶骨性改变常见,常伴有软组织生成;FDG对骨转移病灶的探测效率明显高于CT。Objective Our study was to evaluate characteristics of bone metastases from HCC by ^（18）F-FDG PET/CT. Methods45 patients with bone metastasis（ 191 lesions） from hepatocellular carcinoma,who had undergone PET/CT,were evaluated. Imaging data were analyzed retrospectively based on FDG PET/CT imaging. Metastatic bone lesions were identified with visual inspection on FDG PET/CT,and maximum standardized uptake value（ SUVmax） was used for the quantitative analysis. Confirmation of bone metastasis was based on histopathology,combined imaging modalities,or serial follow-up studies. Results Bone metastases with soft tissue were found in 21 patients. Bone metastases were most frequently found in the spine,followed by the rib cage and pelvis. The major（ 143/191） form of bone destruction was osteolytic change,others（ 48/191） showed higher focal FDG uptake without bone destruction. 64（ 33. 5%） lesions presented with soft tissue formation showed higher uptake of FDG than lesion without soft tissue formation（ 6. 56 ± 3. 64 vs 5. 35 ± 2. 41,P = 0. 034）. FDG PET was more effectively than CT in detecting lesions（ 98% vs 87%）. Conclusion The most common radiographic feature of bone metastases from HCC is an osteolytic lesion,either replaced by soft tissue mass,FDG PET/CT is more sensitive than CT in bone metastasis from HCC.

关 键 词：肝细胞肝癌 骨转移 软组织形成 溶骨性18F-氟代脱氧葡萄糖 

分 类 号：R735.7[医药卫生—肿瘤] R814.42[医药卫生—临床医学]