子宫内膜异位症的 18F-FDG PET/CT表现  

Characteristics of endometriosis in 18F-FDG PET/CT imaging

作　　者：徐明真 刘帅 宋少莉 Xu Mingzhen;Liu Shuai;Song Shaoli(Department of Nuclear Medicine,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Center for Biomedical Imaging,Fudan University,Shanghai Engineering Research Center of Molecular Imaging Probes,Ministry of Education Key Laboratory of Nuclear Physics and Ion Beam Applications,Shanghai 200032,China)

机构地区：[1]复旦大学附属肿瘤医院核医学科、复旦大学上海医学院肿瘤学系、复旦大学生物医学影像研究中心、上海分子影像探针工程技术研究中心、核物理与离子束应用教育部重点实验室,上海200032

出　　处：《中华核医学与分子影像杂志》2023年第10期599-603,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：复旦大学医工结合项目(XM03211178)。

摘　　要：目的:探讨子宫内膜异位症(EMS) 18F-FDG PET/CT影像特征,为临床准确诊断提供有价值的信息。 方法:回顾性收集2016年12月至2021年5月于复旦大学附属肿瘤医院行 18F-FDG PET/CT检查并经病理证实为EMS的21例患者[年龄23~72(44.0±11.4)岁]的临床及影像资料,分析患者的症状体征、糖类抗原(CA)125水平、PET/CT图像上病灶的特点等。根据术中病灶侵犯情况进行评分,以分值≤4为A组(病灶局限在附件区),>4为B组(病灶侵犯多部位)。采用两独立样本 t检验或Mann-Whitney U检验分析2组患者年龄、CA125等临床参数及SUV max、SUV mean、肿瘤代谢体积(MTV)、病灶糖酵解总量(TLG)的差异。 结果:纳入患者中42.9%(9/21)有痛经史,95.2%(20/21)CA125升高。A组和B组患者CA125水平分别为88.4(42.0,351.5)和619.8(72.3,1 420.0) kU/L,CA125越高,病灶累及范围越广( z=-2.32, P=0.041)。患者年龄越大,病灶越倾向局限在附件区( t=-2.10, P=0.049)。2组患者的SUV max分别为3.67±1.78、3.93±1.88,差异无统计学意义( t=0.33, P=0.746);其他代谢参数SUV mean( t=0.79, P=0.446)、MTV( z=-1.16, P=0.245)、TLG( z=-1.16, P=0.245)差异也无统计学意义。约23.8%(5/21)的患者SUV max≥5,其中4例伴有炎性反应。 结论:EMS患者常伴有腹痛和CA125增高,患者年龄越大越倾向于局灶累及附件,CA125水平越高则病灶累及范围越广。 18F-FDG PET/CT显像时EMS病灶代谢的高低与累及范围无关,但当病灶SUV max>5时,常伴有急性炎性反应,容易误诊。ObjectiveTo explore the 18F-FDG PET/CT imaging features in endometriosis(EMS),in order to provide valuable information for accurate clinical diagnosis.MethodsThe clinical and imaging data of 21 patients(age range 23-72(44.0±11.4)years)who underwent 18F-FDG PET/CT imaging in Fudan University Shanghai Cancer Center between December 2016 and May 2021,and were pathologically confirmed to be EMS,were retrospectively collected.The symptoms and signs,carbohydrate antigen(CA)125 levels,and the characteristics of the lesions on PET/CT images were analyzed.According to the intraoperative lesion invasion score,patients were divided into group A with lesion confined to the adnexal region(the score≤4),and group B with multiple sites invaded(the score>4).The differences in age,CA125,SUVmax,SUVmean,metabolic tumor volume(MTV)and total lesion glycolysis(TLG)were analyzed by independent-sample t test or Mann-Whitney U test.ResultsAbout 42.9%(9/21)had a history of dysmenorrhea.CA125 was elevated in 95.2%(20/21)of the patients.CA125 levels of the group A and group B were 88.4(42.0,351.5)and 619.8(72.3,1420.0)kU/L,respectively,which meant the higher the CA125 and the wider the lesion involvement(z=-2.32,P=0.041).The older the patients,the more likely the lesions were confined to the adnexal region(t=-2.10,P=0.049).The SUVmax of the two groups were 3.67±1.78 and 3.93±1.88,respectively(t=0.33,P=0.746).The other metabolic parameters(SUVmean,MTV and TLG)of the 2 groups were not significantly different either(t=0.79,both z=-1.16,P values:0.446,0.245,0.245).About 23.8%(5/21)of patients were with SUVmax greater than 5,and 4 of them had inflammation.ConclusionsEMS patients are often accompanied by abdominal pain and increased CA125.The older the age,the more prone to focal involvement of appendages.The higher the CA125 level,the wider the lesion involvement.The 18F-FDG metabolism level has nothing to do with the scope of the lesion,but when the SUVmax of the lesion>5,it is often accompanied by acute inflammation,which is easy to be mis

关 键 词：子宫内膜异位症 CA-125抗原 正电子发射断层显像术 体层摄影术 X线计算机 氟脱氧葡萄糖F18 

分 类 号：R711.71[医药卫生—妇产科学] R817.4[医药卫生—临床医学]