侵袭性纤维瘤病CT及^(18)F-FDG PET/CT影像特征分析  

Analysis of CT and ^(18)F-FDG PET/CT imaging features of aggressive fibromatosis

作　　者：田伟伟 马拓 赵晓倩 张敬勉[1] 王建方[1] 韩静雅[1] 赵新明[1] TIAN Wei-wei;MA Tuo;ZHAO Xiao-qian;ZHANG Jing-mian;WANG Jian-fang;HAN Jing-ya;ZHAO Xin-mi(Department of Nuclear Medicine,the Fourth Hospital of Hebei Medical University,Shijiazhuang 050011,China)

机构地区：[1]河北医科大学第四医院核医学科,河北石家庄050011

出　　处：《中国临床医学影像杂志》2024年第12期856-860,共5页Journal of China Clinic Medical Imaging

基　　金：河北省卫生健康委医学科学研究课题计划项目(编号:20240856);河北省自然科学基金面上项目(编号:H2023206016)。

摘　　要：目的:总结侵袭性纤维瘤病(Aggressive fibromatosis,AF)的^(18)F-FDG PET/CT及CT影像学特点,探讨其应用价值。方法:回顾性分析诊断为AF的27例患者的临床资料及CT平扫、增强扫描、^(18)F-FDG PET/CT表现。结果:27例AF患者共37个病灶。大部分为单发,腹内多见。首发症状多以扪及肿物或查体发现。病灶Ki-67平均为3%(2%~5%)。病灶表现为^(18)F-FDG轻中度不均匀摄取增高,内见点、片状相对高摄取,或轻度均匀摄取增高,较大病灶的SUVmax及SUVmean并未显著增加,SU-Vmax为3.32±1.12(1.40~5.10),不同部位的SUVmax无明显统计学差异。CT主要表现为膨胀性改变的软组织密度团块影,无完整包膜,易侵犯周围组织或器官,密度多为不均匀或欠均匀,很少出现钙化、囊变、出血或脂肪密度。不同发病部位的AF表现略不同,腹内型易浸润周围组织,尤其是管状结构,腹外型轮廓较光滑,腹壁型沿肌肉长轴生长,病灶相对较大。CT增强扫描呈渐进性轻中度均匀/不均匀强化,动脉期部分病灶内部或边缘见迂曲血管影。结论:^(18)F-FDG PET/CT联合CT增强扫描对AF的诊断及鉴别诊断具有重要价值。Objective:To summarize the imaging characteristics of ^(18)F-FDG PET/CT and CT in aggressive fibromatosis(AF)and evaluate its application value.Methods:The clinical data,CT plain scan,enhanced scan,and ^(18)F-FDG PET/CT findings of 27 cases diagnosed with AF were retrospectively analyzed.Results:A total of 37 lesions from 27 patients with AF were included,most of these were solitary.Intra-abdominal type was more common.First symptoms of the disease appeared incidentally during imaging examination or physical examination.Tumor proliferation antigen marker Ki-67 was 3%(2%~5%).All the lesions showed FDG uptake,which showed slightly or moderately uptake,with relatively high uptake in the inner or slightly uniform uptake.Even if the larger lesion did not increase significantly in maximum standardized uptake value(SU-Vmax),which ranged from 1.40 to 5.10,with an average value of 3.32±1.12.There were no significant differences in SUVmax of different lesion locations.Most lesions presented as soft tissue masses with expansion growth type on CT scanning,which were round-like,incomplete envelope.The boundaries of most of the lesions were not clear.The lesions presented as relatively uneven.There were rarely present with calcification,cystic changes,hemorrhage or fat.AF in different locations of onset showed diverse CT manifestations.The intra-abdominal AF was easy to infiltrate the abdomino-pelvic organs and surrounding tissues,especially tubular structures.The extra-abdominal AF was smooth.The abdominal wall AF growed along the long axis of the muscle,and the lesions were relatively larger.The enhanced CT images showed progressive enhancement.Mild to moderate unifom or non-unifom reinforcement was observed.Some lesions showed tortuous vascular shadows inside or at the edges in the arterial phase.Conclusion:The combined application of ^(18)F-FDG PET/CT and CT can provide diagnosis and differential diagnosis information of AF.

关 键 词：纤维瘤病 侵袭型 体层摄影术 X线计算机 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：R738.6[医药卫生—肿瘤] R814.42[医药卫生—临床医学] R817.4