^18F-FDG PET/CT显像诊断以发热待查为主要表现的脂膜炎  

^18F-FDG PET/CT imaging in detection of panniculitis presenting as fever of unknown origin

作　　者：赵赟赟[1] 王茜[1] 李原[1] 高平[1] Zhao Yunyun;Wang Qian;Li Yuan;Gao Ping(Department of Nuclear Medicine,Peking University People′s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院核医学科,100044

出　　处：《中华核医学与分子影像杂志》2020年第8期459-463,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

摘　　要：目的探讨^18F-脱氧葡萄糖(FDG)PET/CT在脂膜炎导致发热待查(FUO)中的应用价值。方法回顾性分析2013年1月至2019年12月间以FUO就诊于北京大学人民医院并行^18F-FDG PET/CT检查的503例患者,将其中临床最终诊断为脂膜炎的患者纳入研究,分析纳入者的临床和影像资料。结果503例FUO患者中最终临床诊断为脂膜炎者占0.99%(5/503)。5例脂膜炎患者中3例为女性,年龄41~76岁,临床表现主要为发热,实验室检查均有血红细胞沉降率和C反应蛋白升高。^18F-FDG PET/CT显像在多个脂肪分布区发现局限性放射性摄取增高灶,其中位于皮下脂肪3例、位于肠系膜3例、位于腹腔及腹膜后其他脂肪组织1例,最大标准摄取值(SUVmax)为0.8~5.0。5例中4例有脾脏弥漫性摄取增高,3例有骨髓弥漫性摄取增高,2例有多发反应性增生小淋巴结影;另外,在扫描野延长至小腿中段的2例患者中可见多关节滑膜FDG高摄取现象。结论脂膜炎在^18F-FDG PET/CT显像中具有一定特征,^18F-FDG PET/CT有助于脂膜炎所致FUO的病因诊断。Objective To explore the clinical value of^18F-fluorodeoxyglucose(FDG)PET/CT in panniculitis presenting as fever of unknown origin(FUO).Methods Patients with FUO(n=503)who underwent^18F-FDG PET/CT examination in Peking University People′s Hospital between January 2013 and December 2019 were retrospectively analyzed,and those with final diagnosis of panniculitis were enrolled.The clinical and imaging data of patients with panniculitis were evaluated.Results Five of the 503(0.99%)patients with FUO who underwent PET/CT imaging were diagnosed with panniculitis.Their age ranged from 41 to 76 years,and 3 of them were females.The main clinical manifestation was fever.Laboratory tests showed an increase in erythrocyte sedimentation rate and C-reactive protein.The^18F-FDG PET/CT imaging found localized FDG uptake foci in multiple adipose tissue,with maximum standardized uptake value(SUVmax)ranging from 0.8 to 5.0.Those lesions located in subcutaneous adipose tissue(n=3),mesenteric adipose tissue(n=3)and other adipose tissue in abdominal cavity and retro peritoneum(n=1).Diffusely increased FDG uptake of the spleen was found in 4 patients,diffusely increased FDG uptake of bone marrow was found in 3 patients,and multiple reactive hyperplasia lymph nodes was found in 2 patients.In addition,in 2 patients with the scanning field extended to the mid-thigh,high FDG uptake of the polyarticular synovium was also seen.Conclusions Panniculitis has some characteristics on^18F-FDG PET/CT imaging.^18F-FDG PET/CT is helpful for etiological diagnosis of FUO caused by panniculitis.

关 键 词：脂膜炎 发热 正电子发射断层显像术 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R572.3[医药卫生—消化系统] R816.5[医药卫生—内科学]