18F-FDG PET/MR全身显像在儿童肾母细胞瘤分期中的应用价值  

Application Value of~(18)F-FDG PET/MR Whole Body Imaging in the Staging of Wilms Tumor in Children

作　　者：沈阳 许远帆 梁江涛 孙黎清 谌海波 SHEN Yang;XU Yuan-fan;LIANG Jiang-tao;SUN Li-qing;CHEN Hai-bo(Department of Nuclear Medicine,the Affliated Suzhou Hospital of Nanjing University Medical School,Suzhou 215153,Jiangsu Province,China;Hangzhou Panoramic Medical Imaging Diagnosis Center,Hangzhou 310002,Zhejiang Province,China;Department of radiology,Guangfu People's Hospital,Suzhou 215200,Jiangsu Province,China;Department of radiotherapy,the Affliated Suzhou Hospital of Nanjing University Medical School,Suzhou 215153,Jiangsu Province,China)

机构地区：[1]南京大学医学院附属苏州医院核医学科,江苏苏州215153 [2]杭州全景医学影像诊断中心,浙江杭州310002 [3]光福人民医院放射科,江苏苏州215200 [4]南京大学医学院附属苏州医院放疗科,江苏苏州215153

出　　处：《中国CT和MRI杂志》2025年第2期131-133,共3页Chinese Journal of CT and MRI

基　　金：浙江省医药卫生科技计划项目(2024KY1428)。

摘　　要：目的分析和探讨18F-FDG PET/MR全身显像在儿童肾母细胞瘤(WT)分期中的应用价值。方法回顾性分析本中心2018年1月至2021年6月收治的77例WT患儿临床资料,分为治疗前组(n=40)和治疗后组(n=37),均进行18F-FDG PET/MR全身显像检查,观察肿瘤的大小、形态、信号特征,与周围组织的关系,病灶原发灶ROI最大标准摄取值(SUVmax),转移情况及其分期特征。结果治疗前组右肾、左肾单发分别为20例(50.00%)、17例(42.50%),2例(5.00%)发生在两肾,1例(2.50%)发生于肾外,病灶最大径多为上下径,最大径(10.25±4.12)cm,其中8例(20.00%)跨中线,SUVmax值为(13.58±6.74),肿块边界光滑清楚有假包膜的28例(70.00%),肿瘤内密度不均,有坏死、出血、囊变的26例(65.00%),28例(70.00%)可见“残肾征”,8例(20.00%)为全肾侵犯型;40例治疗前例患儿包括Ⅰ期3例(7.5%),Ⅱ期5例(12.5%),Ⅲ期14例(35.0%),Ⅳ期16例(40.0%),Ⅴ期2例(5.0%),PET/MR显像后,治疗前组有15例(37.50%)分期发生改变,其中11例(27.5%)由Ⅲ期提高到Ⅳ期,4例(10.00%)由Ⅱ期提高到Ⅳ期,37例治疗后组患儿在PET/MR显像后有12例(32.40%)分期发生改变,其中7例(18.92%)由0期提高到Ⅳ期,2例(5.40%)由Ⅲ期提高到Ⅳ期,3例(8.10%)因PET/MR摄取阴性而降低分期,两组PET/MR显像前、后分期比较,差异均有统计学意义(P<0.05);治疗前组和治疗后组淋巴结转移分别为21例(52.50%)、12例(32.43%),远处转移分别为17例(42.50%)、10例(27.00%)。结论18F-FDG PET/MRI对WT分期的诊断价值优于临床分期,在探查肿瘤周围侵犯和远处转移更具优势,明显提高了肿瘤的原始分期及再分期的准确性。Objective To analyze and discuss the application value of~(18)F-FDG PET/MR whole body imaging in the staging of Wilms tumor(WT)in children.Methods The clinical data of 77 children with WT in our center from January 2018 to June 2021 were retrospectively analyzed.The children were divided into pre-treatment group(n=40)and post-treatment group(n=37).All children underwent~(18)F-FDG PET/MR whole body imaging.The tumor size,shape,signal characteristics,relationship with surrounding tissue,maximum standard uptake value(SUVmax)of the primary lesion ROI,metastasis status and staging characteristics were observed.Results In pre-treatment group,20 cases(50.00%)occurred in single right kidney,17 cases(42.50%)occurred in single left kidney,2 cases(5.00%)occurred in both kidneys and 1 case(2.50%)occurred outside the kidney,and the maximum diameter of the lesion was mostly upper-lower diameter,and the maximum diameter was(10.25±4.12)cm.Among them,8 cases(20.00%)crossed the midline,and the SUVmax value was(13.58±6.74).There were 28 cases(70.00%)with smooth and clear pseudocapsule,26 cases(65.00%)with uneven density,necrosis,hemorrhage and cystic degeneration,28 cases(70.00%)with“remnant kidney sign”,and 8 cases(20.00%)of whole kidney invasion type.40 cases of children before treatment included 3 cases of stageⅠ(7.5%),5 cases of stageⅡ(12.5%),14 cases of stageⅢ(35.0%),16 cases of stageⅣ(40.0%)and 2 cases of stageⅤ(5.0%).After PET/MR imaging,15 cases(37.50%)in pre-treatment group had staging changes,of which 11 cases(27.5%)were increased from stageⅢto stageⅣand 4 cases(10.00%)were increased from stageⅡto stageⅣ.Among 37 children in post-treatment group,12 cases(32.40%)had staging changes after PET/MR imaging,of which 7 cases(18.92%)were risen from stage 0 to stageⅣ,2 cases(5.40%)were increased from stageⅢto stageⅣ,and 3 cases(8.10%)were decreased due to negative PET/MR uptake.There was a statistically significant difference in the staging between both groups before and after PET/MR imaging(P<0.05).T

关 键 词：儿童 肾母细胞瘤 18F-FDG PET/MR全身显像 临床分期 

分 类 号：R179[医药卫生—妇幼卫生保健]