弥漫大B细胞淋巴瘤^(18)F-FDG PET/CT特点及预测骨髓浸润的价值  

Characteristics of ^(18)F-FDG PET/CT and Predictive Value for Bone Marrow Infiltration in Diffuse Large B-cell Lymphoma

作　　者：杨满[1] 黄琰[1] 孙凤霞[2] 张灵秀[1] 朱璐遥 刘宪凯 王秀峰 YANG Man;HUANG Yan;SUN Feng-xia;ZHANG Ling-xiu;ZHU Lu-yao;LIU Xian-kai;WANG Xiu-feng(Blood Disease Ward One,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang's Leading Laboratory for the Molecular Diagnosis and Treatment of Lymphoma,Xinxiang 453100,Henan Province,China;Department of Nuclear Medicine,The First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100,Henan Province,China)

机构地区：[1]新乡医学院第一附属医院血液病一病区新乡市淋巴瘤分子诊疗重点实验室,河南新乡453100 [2]新乡医学院第一附属医院核医学科,河南新乡453100

出　　处：《中国CT和MRI杂志》2025年第1期180-182,共3页Chinese Journal of CT and MRI

基　　金：新乡市科技攻关项目(GG2020029);2019年度新乡医学院第一附属医院青年培育基金项目(QN-2019-B01);河南省医学科技攻关计划项目(LHGJ20210533)。

摘　　要：目的探讨弥漫大B细胞淋巴瘤(DLBCL)18氟-脱氧葡萄糖(^(18)F-FDG)正电子发射断层/计算机断层扫描(PET/CT)特点及预测骨髓浸润的价值。方法回顾性分析70例经病理确诊为DLBCL患者的^(18)F-FDG PET/CT影像资料,以PET/CT存在局灶性骨髓浸润灶认定为骨髓浸润,根据是否发生骨髓浸润分为骨髓浸润组和骨髓正常组。其中骨髓浸润组分为局部浸润、弥漫浸润、局部伴弥漫浸润三组。观察代谢参数最大标准化摄取值(SUVmax)、肿瘤代谢体积(MTV)、病灶糖酵解总量(TLG)值,使用Spearman分析影像参数与Ann Arbor分期的相关性。绘制受试者工作特征曲线(ROC)分析PET/CT对骨髓浸润的诊断价值。结果经^(18)F-FDG PET/CT检查发现,骨髓浸润16例(22.86%),骨髓正常54例(78.14%),骨髓浸润中,局部浸润2例(12.50%)、弥漫浸润4例(25.00%)、局部伴弥漫浸润10例(62.50%);对比骨髓浸润组与骨髓正常组的^(18)F-FDGPET/CT参数发现,骨髓浸润组SUVmax、MTV和TLG值均高于骨髓正常组(P<0.05);对比不同临床分期的^(18)F-FDG PET/CT参数发现,4个临床分期的SUVmax、MTV和TLG值差异显著,均随着临床分期的进程而升高(P<0.05);Spearman分析显示,SUVmax、MTV和TLG与临床分期均成正相关(r=0.944,r=0.569,r=0.982,P均<0,001);SUVmax、MTV和TLG诊断骨髓浸润的AUC的面积分别为0.999、0.700、0.994(P均<0.05)。结论^(18)F-FDG PET/CT诊断DLBCL患者效能较高,其影像参数均呈现较高水平,与临床分期具有相关性,且其对骨髓浸润诊断价值较高。Objective To explore the characteristics of 18fluoro-deoxyglucose(^(18)F-FDG)positron emission tomography/computed tomography(PET/CT)and predictive value for bone marrow infiltration in diffuse large B-cell lymphoma(DLBCL).Methods A retrospective analysis was performed on ^(18)F-FDG PET/CT imaging data of 70 patients who were pathologically confirmed with DLBCL.According to presence or absence of bone marrow infiltration(focal bone marrow infiltration in PET/CT),patients were divided into infiltration group and normal groupThe patients in infiltration group were divided into local infiltration group,diffuse infiltration group and local-diffuse infiltration group.The metabolic parameters[maximum standardized intake(SUVmax),metabolic tumor volume(MTV),total lesion glycolysis(TLG)]were observed,the correlation between imaging parameters and Ann Arbor staging was analyzed by Spearman,and diagnostic value of PET/CT in bone marrow infiltration was analyzed by receiver ope rating characteristic(ROC)curves.Results ^(18)F-FDG PET/CT showed that there we re16 cases(22.86%)with bone marrow infiltration and 54 cases(78.14%)with normal bone marrow.In bone marrow infiltration,there were 2 cases(12.50%)with local infiltration,4 cases(25.00%)with diffuse infiltration and 10 cases(62.50%)with local and diffuse infiltration.SUVmax,MTV and TLG in infiltration group were higher than those in normal group(P<0.05).There were significant differences in SUVmax,MTV and TLG among patients with different disease staging,and which were all increased with the increase of staging(P<0.05).Spearman analysis showed that SUVmax,MTV and TLG were positively correlated with disease staging(r=0.944,r=0.569,r=0.982,P<0.001).AUC of SUVmax combined with MTV and TLG in the diagnosis of bone marrow infiltration was 0.999,0.700,0.994(P<0.05).Conclusion The diagnostic efficiency of ^(18)F-FDG PET/CT is high in DLBCL patients,and its imaging parameters are at a high level,which are correlated with disease staging and have high diagnostic value in bone marrow

关 键 词：弥漫大B细胞淋巴瘤 ^(18)氟-脱氧葡萄糖 PET/CT 骨髓浸润 

分 类 号：R551.3[医药卫生—血液循环系统疾病]