摘要
目的回顾性评价18F-FDG PET/CT联合诊断性CT对周围型神经鞘瘤的诊断价值。方法本研究包括经病理证实为神经鞘瘤病例20例,男性8例,女性12例,年龄40~83岁,平均年龄(63.3±14.0)岁。所有患者均进行了18FFDG PET/CT全身显像及病灶层面三期增强扫描,分析内容包括SUVmax、部位、直径、形态、边缘、密度、强化方式及峰值、对邻近骨的侵犯。结果 20例病例中有16例是偶然发现的;20例病例均是单发病灶,病灶形态为椭圆形(15例)或圆形(5例)。7例位于脊柱旁,3例位于锁骨上窝,4例位于胸膜,4例位于颈部,右侧股部、背部各1例。4例有邻近骨侵犯。肿瘤的平均直径为(2.84±1.04)cm(范围,1.5~5.8cm),平均CT值约为(24.2±10.5)HU(范围,-2.2~39.2HU),肿瘤直径与CT平扫密度值之间无相关性(P=0.199)。CT平扫密度值15例为低于肌肉密度,5例等于肌肉密度。病灶层面三期增强扫描,14例表现为均匀强化,6例为不均匀强化;中度强化14例,高度强化6例;均未发现邻近血管侵犯,但1例病灶内见钙化灶。PET/CT显像病灶呈轻度到高度18F-FDG摄取,平均SUVmax为2.88±1.06(范围为1.0~5.3)。SUVmax与肿瘤直径及CT密度值之间均无相关性(P=0.028,P=0.045)。结论尽管神经鞘瘤可以表现为18F-FDG高摄取,但CT平扫及增强扫描对神经鞘瘤的术前诊断及治疗计划非常有帮助。
Objective To retrospectively assess the imaging findings of peripheral nerve schwannoma in18F-FDG PET/CT combined with diagnosis CT. Methods Twenty patients with pathologically confirmed schwannomas were included in the study（ 8 men and 12 women; age range,40 ~ 83 years; mean age,63. 3 ± 14. 0 years）.18F-FDG PET/CT imaging and contrast-enhanced CT in twenty patients were analyzed,including the SUVmax,location,diameter,shape,margin,attenuation,enhancement pattern and extent,invasion into adjacent bone,all of which were observed and recorded. Results Most cases（ 16/20）were incidentally detected. All of the tumors were solitary and ovoid（ n = 15） or round（ n = 5） in shape. Seven tumors were located in the paravertebral and three were found in the supraclavicular fossa and four were found in hemithorax and four were found in cervical part and the other two were found in the right thigh and back individually. The average diameter of the tumors was（ 2. 84± 1. 04） cm（ range,1. 5 ~ 5. 7 cm）. The average CT Hunsfield Unit（ HU） was（ 24. 2 ± 10. 5） HU（ range,-2. 2 to 39. 2HU）. There was no correlation between Hu and diameter（ P = 0. 199）. Schwannomas on unenhanced CT showed either hypoattenuation（ fifteen cases） or isoattenuation（ five cases） to the muscles. The tumors appeared homogenous considering attenuation in fourteen patients and heterogeneous in six patients on contrast-enhanced CT. Twenty tumors showed mild（ fourteen cases） to marked（ six cases） enhancement on contrast-enhanced CT. Associated features,including vessel invasion,were absent in all cases,but one case showed calcification. The mean SUVmax for schwannoma was 2. 88 ± 1. 06（ range： 1. 0 ~ 5. 3）. There was correlation both between SUVmax and diameter and Hu（ P = 0. 028,P = 0. 045）. Conclusion Although schwannomas may show high accumulation in18F-FDG PET/CT imaging,unenhancement and enhancement CT are helpful for preoperative diagnosis and surgical planning in patients with schwannomas.
出处
《医学影像学杂志》
2017年第6期1024-1027,1031,共5页
Journal of Medical Imaging
