摘要
目的分析胃惰性淋巴瘤与侵袭性淋巴瘤的18F-2-氟-2-脱氧-D-葡萄糖(18F-FDG)PET/CT影像学特点,探讨其在胃淋巴瘤的诊断、鉴别诊断和分期中的价值。方法对26例经胃镜活检病理证实的胃非霍奇金淋巴瘤(包括19例侵袭性淋巴瘤,其中弥漫大B细胞淋巴瘤16例,间变性大细胞淋巴瘤、T淋巴母细胞性淋巴瘤和套细胞淋巴瘤各1例;7例惰性淋巴瘤,其中黏膜相关淋巴组织结外边缘区B细胞淋巴瘤(MALT)6例、结外性滤泡边缘区B细胞性淋巴瘤1例)进行了治疗前常规PET/CT显像。结果胃淋巴瘤的PET/CT表现以不同形式的胃壁增厚和FDG代谢显著增高为主要特征,部分有胃外侵犯。在胃壁增厚方面,侵袭性淋巴瘤与惰性淋巴瘤分别有7例及3例呈Ⅰ型表现(胃壁弥漫性增厚伴FDG代谢显著增高),5例及0例呈Ⅱ型表现(胃壁节段性增厚伴FDG代谢显著增高),6例及3例呈Ⅲ型表现(胃壁局限性增厚伴FDG代谢增高),1例及1例呈Ⅳ型表现(胃壁多发结节样增厚伴FDG代谢串珠样增高)。在FDG代谢方面,侵袭性胃淋巴瘤SUVmax平均值为13.1,而惰性胃淋巴瘤为4.3,两者差异有统计学意义(P<0.05)。受试者工作特征曲线(ROC)分析显示,当临界值为5.35时,曲线下面积最大,此时鉴别惰性与侵袭性胃淋巴瘤的灵敏度可达84.2%,特异度为85.7%。结论胃非霍奇金淋巴瘤的18F-FDG PET/CT表现以Ⅰ型和Ⅲ型多见,侵袭性淋巴瘤的SUVmax高于惰性淋巴瘤。18F-FDG PET/CT有助于淋巴瘤的诊断和病情全面评估。
Objective To analyze the18F-fluorodeoxyglucose(18F-FDG) PET/CT in patients with gastric indolent lymphoma and aggressive lymphoma, and to investigate the value of18F-FDG PET/CT in diagnosis, differentiation and staging of gastric lymphoma. Methods Twenty-six patients with endoscope histopathologically confirmed non-Hodgkin’s lymphoma(NHL) underwent18F-FDG PET/CT imaging before treatment. Nineteen of them were aggressive lymphoma including 16cases with diffused large B cell lymphoma(DLBCL), 1 case with anaplastic large cell lymphoma, 1 case with T lymphoblastic lymphoma, and 1 case with mantle cell lymphoma. Seven of them were indolent lymphoma including 6 cases with mucosaassociated lymphoid tissue(MALT) lymphoma, and 1 case with follicular lymphoma. Results The PET/CT findings of gastric lymphoma showed diverse thickened gastric wall with significantly high FDG uptake, and some showed extragastric encroachment. In the patients with gastric aggressive lymphoma and indolent lymphoma, there were 7 and 3 with pattern I(diffuse thickening of gastric wall with significantly high FDG uptake), 5 and 0 with pattern Ⅱ(segmental thickening of gastric wall with significantly high FDG uptake), 6 and 3 with pattern Ⅲ(local thickening of gastric wall with high FDG uptake), 1 and1 with pattern Ⅳ(multiple nodular thickening of gastric wall with high FDG uptake as string-of-boads appearance). Gastric aggressive lymphoma had a higher FDG uptake than gastric indolent lymphoma, with a SUVmax of 13.1 and 4.3 respectively(P<0.05). The receiver operating characteristic curve(ROC) showed that when 5.35 was set as threshold the sensitivity was84.2% and specificity was 85.7%, respectively. Conclusion The pattern I and pattern Ⅲ of 18F-FDG PET/CT findings are most common in gastric lymphoma.Gastric aggressive lymphoma has a higher FDG uptake than gastric indolent lymphoma.18FFDG PET/CT is of value in the diagnosis and overall assessment of lymphoma before treatment.
出处
《肿瘤影像学》
2013年第3期203-206,共4页
Oncoradiology
基金
上海市优秀学科带头人计划项目(No:11XD1403700)
