^(18)F-FDG PET/CT在脂膜炎性T细胞淋巴瘤中的应用  

Application of^(18)F-FDG PET/CT in subcutaneous panniculitis-like T cell lymphoma

作　　者：代若雪 傅丽兰 吴湖炳[1] 王巧愚[1] 李洪生[1] DAI Ruo-xue;FU Li-lan;WU Hu-bing;WANG Qiao-yu;LI Hong-sheng(Department of Nuclear Medicine,Nanfang Hosptial,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院核医学科,广东广州510515

出　　处：《中国临床医学影像杂志》2021年第12期894-897,共4页Journal of China Clinic Medical Imaging

基　　金：广东省自然科学基金项目(2020A1515011014)。

摘　　要：目的:探讨^(18)F-FDG PET/CT在脂膜炎性T细胞淋巴瘤(SPTCL)诊疗中的应用价值。方法:选择2007年8月—2021年6月经病理确诊为SPTCL且治疗前行^(18)F-FDG PET/CT检查的13例患者,回顾性分析其^(18)F-FDG PET/CT影像学表现(病灶的分布、大小、最大标准摄取值(SUVmax)等),分析^(18)F-FDG PET/CT影像学表现与IPI评分等临床信息的关系,并初步探讨^(18)F-FDG PET/CT显像对SPTCL疗效评估的价值。结果:^(18)F-FDG PET/CT影像学表现:皮肤受累13例,病变多位于躯干和四肢,SUVmax为8.16±1.66(躯干:6.53±1.32,四肢:3.61±0.32);淋巴结受累6例,最大径为(1.30±0.12) cm,SUVmax为4.74±1.03,最大径与SUVmax呈正相关(P=0.031);骨髓受累7例,SUVmax为4.77±2.92;脾脏受累2例,SUVmax为2.85±0.92;其他脏器受累9例,SUVmax为4.43±0.79。IPI高危组患者9例,病灶SUVmax更高(P=0.035),皮肤受累部位更多(P=0.047)。有效随访6例,完全缓解2例,部分缓解2例,复发2例,其中3例经PET/CT检查后改变治疗方案获得缓解。结论:在^(18)F-FDG PET/CT显像上SPTCL病灶均表现为高代谢,因此^(18)F-FDG PET/CT显像可用于SPTCL的诊断、分期、疗效评价等方面,具有进一步临床推广的应用潜能。Objective: To investigate the application of^(18)F-FDG PET/CT in subcutaneous panniculitis-like T cell lymphoma(SPTCL). Methods: The study retrospectively analyzed the clinical and^(18)F-FDG PET/CT data before treatment of 13 patients with SPTCL diagnosed pathologically from August 2007 to June 2018. The size, distribution, the maximum standardized uptake values(SUVmax) of lymphoma lesions in^(18)F-FDG PET/CT were collected and analyzed. The relationships between the characteristic of^(18)F-FDG PET/CT and clinical information(such as IPI scores) in SPTCL patients were analyzed. The value of^(18)F-FDG PET/CT in the treatment determination and efficacy evaluation was explored. Results: All the 13 patients displayed the skin involvement with SUVmax 8.16 ±1.66, most commonly on the extremities with SUVmax 6.53 ±1.32 and trunk with SUVmax 3.61±0.32. Six cases of SPTCL showed lymph nodes invasion, whose maximum diameter was(1.30±0.12) cm and SUVmax was 4.74±1.03, there was a positive between the maximum and SUVmax of lymph node involvements(P=0.031). Seven cases of SPTCL showed bone marrow involvement with SUVmax 4.77 ±2.92. Two cases of SPTCL showed splenomegaly with SUVmax 2.85 ±0.92. The SUVmax of other extranodal involvements was 4.43 ±0.79. There were 9 patients in IPI high-risk group. The IPI high-risk group had higher SUVmax of the lesions(P=0.035) and wider distribution of the skin lesions(P=0.047)than in the low-risk group. In 6 cases of SPTCL with effective follow-up, 2 patients showed complete response(CR), 2 patients showed partial response(PR), 2 patients showed recurrence. Among them, 3 patients were relieved because of the treatment change after PET/CT checking. Conclusion:^(18)F-FDG PET/CT is of great value in the diagnosis, staging, efficacy evaluation, and monitoring prognosis of SPTCL, and has the potential for further clinical application.

关 键 词：淋巴瘤 T细胞 氟脱氧葡萄糖F18 正电子发射断层显像计算机体层摄影术 

分 类 号：R733[医药卫生—肿瘤] R817.4[医药卫生—临床医学]