腹膜后脂肪肉瘤的PET/CT影像学特点  

PET/CT Manifestations of Different Pathological Subtypes of Retroperitoneal Liposarcoma

作　　者：周妮娜[1] 李囡[1] 王雪鹃[1] 朱华[1] 范洋 杨志[1] ZHOU Ni＇na;LI Nan;WANG Xuejuan;ZHU Hua;FAN Yang;YANG Zhi(Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Nuclear Medicine, Peking University Cancer Hospital ＆Institute, Beijing 100142, China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所核医学科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142

出　　处：《肿瘤防治研究》2018年第5期316-319,共4页Cancer Research on Prevention and Treatment

基　　金：国家自然科学基金(81571705;81501519)

摘　　要：目的分析不同病理亚型腹膜后脂肪肉瘤的PET/CT影像学表现,探讨PET/CT在腹膜后脂肪肉瘤中的应用价值。方法搜集经手术病理证实的腹膜后脂肪肉瘤48例,根据WHO2013版软组织肿瘤分类及FNCCLE分级,分为G1组(9例高分化),G2组(7例黏液样),G3组(29例去分化、2例多形性、1例圆形细胞脂肪肉瘤)。分析不同病理亚型脂肪肉瘤的CT表现,比较不同分级组间FDG代谢的程度及代谢均匀度的差异,统计学方法采用方差齐性检验。结果 (1)高分化型以脂肪密度为主,内有索条和(或)小结节伴轻度代谢;黏液样型为代谢轻度增高的稍低密度肿块,伴或不伴脂肪;去分化、多形性、圆形细胞型为高代谢软组织肿块,伴或不伴脂肪;(2)48例均有局部浸润,无淋巴结转移,1例复发去分化型纵隔转移,1例圆形细胞型腹膜种植转移;(3)SUV_(max)值G1<G2<G3(2.6±1.6,4.6±2.4,9.8±9.3),G1与G3组间差异有统计学意义(P<0.05),余各组间差异无统计学意义。结论不同亚型腹膜后脂肪肉瘤PET/CT表现不同,术前PET/CT可以准确判断肿瘤范围及转移情况,初步判断肿瘤病理亚型,帮助指导手术方案设计。Objective To analyze PET/CT imaging manifestations of different pathological subtypes of retroperitoneal liposarcoma, to explore the application value of PET/CT in retroperitoneal liposarcoma. Methods We included 48 patients diagnosed pathologically as retroperitoneal liposarcoma. According to the classification of WHO2013 soft tissue tumor and FNCCLE criterion, the patients were divided into three groups, G1 group included nine well-differentiated liposarcoma（WDLS）, G2 group included seven myxoid liposarcoma（MLS）, and G3 group included 29 dedifferentiated liposarcoma（DDLS）, two pleomorphic liposarcoma（PLS）, and one round cell liposarcoma（RCLS）. PET/CT manifestations of different subtypes of retroperitoneal liposarcoma were analyzed. FDG metabolic degree and uniformity among three groups were compared by ANOVA test. Results（1） WDLS showed fat density mass with septa and small nodules, with mild FDG uptake; MLS showed low density mass with mild to moderate FDG uptake, with or without fat; DDLS/PLS/RCLS showed soft tissue mass with high FDG uptake, with or without fat;（2）All lesions had local invasion, without lymph node metastasis; one recurrent DDLS had meditational metastasis; one RCLS had peritoneal metastasis;（3）The mean SUVmax G1〈G2〈G3（2.6±1.6, 4.6±2.4, 9.8±9.3）, there was significant difference between G1 and G3 groups（P〈0.05）. Conclusion Different subtypes of retroperitoneal liposarcoma have different PET/CT manifestations. Preoperative PET/CT could accurately show the extent and metastasis of tumor and predict the pathological subtype, which could help the design of surgical scheme.

关 键 词：腹膜后脂肪肉瘤 PET/CT 代谢 病理亚型 FNCCLE分级 

分 类 号：R738.6[医药卫生—肿瘤]