常见骨质破坏的18F-FDG PET/CT显像及实验室特点  

Characteristics of 18F-FDG PET/CT imaging and laboratory indicators in common bone destructions

作　　者：王寻 葛双 孔钰 程楠[1] 张谷青[1] WANG Xun;GE Shuang;KONG Yu;CHENG Nan;ZHANG Guqing(Department of Medical Imaging,Affiliated Hospital of Jining Medical University,Jining 272000,China;Department of Tumor Radiotherapy,Affiliated Hospital of Jining Medical University,Jining 272000,China)

机构地区：[1]济宁医学院附属医院医学影像科,山东济宁272000 [2]济宁医学院附属医院肿瘤放疗科,山东济宁272000

出　　处：《医学影像学杂志》2023年第12期2265-2269,共5页Journal of Medical Imaging

摘　　要：目的探讨骨髓瘤、骨淋巴瘤及骨转移瘤18F-脱氧葡萄糖(18F-FDG)PET/CT影像学特征及实验室特点,提高对三种疾病的认识。方法选取本院行18F-FDG PET/CT检查,并经病理或临床证实为骨髓瘤、骨淋巴瘤及骨转移瘤的107例患者资料,其中骨髓瘤36例,骨淋巴瘤24例,骨转移瘤47例,对比三组实验室相关指标、病灶分布、骨破坏形态及代谢程度等。结果三组的发病年龄及性别差异无统计学意义,骨髓瘤更易出现贫血、β2微球蛋白及球蛋白升高,骨淋巴瘤更易出现乳酸脱氢酶升高、血沉加快,骨转移瘤可见肿瘤标志物升高。三者均好发于富含红骨髓的部位,骨髓瘤较骨转移瘤更易发生于颅骨,差异有统计学意义(P<0.05);病理性骨折发生率为骨髓瘤>骨转移瘤>骨淋巴瘤,差异有统计学意义(P<0.05);三者均可合并有软组织肿块,但差异无统计学意义(P>0.05)。骨髓瘤以溶骨型骨质破坏为主,多为虫蚀样、穿凿样,边界清晰,骨轮廓呈“破而不烂”,可见典型“微脑征”;骨淋巴瘤以溶骨及骨髓浸润型为主,典型表现为轻微骨质破坏伴较大软组织肿块,部分可见“融冰征”;骨转移瘤表现多样,PET/CT对原发灶的检出率约为91.5%。三者代谢程度为骨淋巴瘤>骨转移瘤>骨髓瘤,差异有统计学意义(P<0.05)。结论骨髓瘤、骨淋巴瘤及骨转移瘤有其各自的18F-FDG PET/CT影像学及实验室特点,综合分析可提高对三者的认识。Objective To investigate the characteristics of 18F-fluorodeoxyglucose(FDG)PET/CT imaging and clinical labo-ratory indicators of the myeloma,bone lymphoma and bone metastasis,and to improve the understanding of them.Methods 107 patients who underwent 18F-FDG PET/CT examination in our center were confirmed to be myeloma(n=36),bone lymphoma(n=24)and bone metastasis(n=47)were retrospectively analyzed.The laboratory indicators,distribution,morphology and me-tabolism of bone destruction lesions were compared in the three groups.Results There was no significant difference in age and gender between the three groups.Myeloma was more likely to have anemia,increasedβ2 microglobulin and globulin,bone lym-phoma was more likely to have increased lactate dehydrogenase,rapid erythrocyte sedimentation rate,while bone metastasis could be accompanied by increased tumor markers.They were more likely to occur in areas rich in red bone marrow.Myeloma was more likely to occur in the skull than bone metastasis,and the difference between them was statistically significant,P<0.05.The incidence of pathological fracture was myeloma>bone metastasis>bone lymphoma,and the difference between them was sta-tistically significant,P<0.05.There was no statistical difference in the incidence of soft tissue masses.Myeloma was dominated by osteolytic bone destruction,most of which was represented as“insect-bite-like”or“chisel-like”with clear boundary.The bone outline was“broken but not rotten”,and typical“mini brain sign”could be seen.Bone lymphoma was dominated by osteo-lytic type and bone marrow infiltration type.The typical manifestation was slight bone destruction with large soft tissue mass,and some showed“ice melt sign”.Bone metastasis represented variously.The detection rate of PET/CT for primary tumors was about 91.5%.The metabolic degree of the three groups was bone lymphoma>metastasis>bone myeloma,with statistical differ-ence(P<0.05).Conclusion Myeloma,bone lymphoma and bone metastasis have their own 18F-FDG PET/CT imagi

关 键 词：骨髓瘤 骨淋巴瘤 骨转移瘤 正电子发射断层显像技术 氟脱氧葡萄糖 实验室指标 

分 类 号：R738.1[医药卫生—肿瘤] R817.4[医药卫生—临床医学]