摘要
目的:探讨多发性骨髓瘤(MM)患者18F-氟代脱氧葡萄糖正电子发射型计算机断层显像/计算机体层成像(18F-FDG PET/CT)的影像学特征,分析其在MM与骨转移瘤中的应用价值。方法:回顾性分析2017年1月至2019年3月海南西部中心医院收治的均行18F-FDG PET/CT检查的72例MM和50例骨转移瘤患者。观察2组患者病灶分布部位、骨质破坏形态、最大标准化摄取值(SUVmax)及代谢均匀性变化。结果:MM与骨转移瘤的病灶部位80%以上累及胸部骨、脊柱及骨盆,其次好发于四肢。MM发生于胸部骨及颅骨的病灶部位比骨转移瘤明显多见(P<0.05)。MM患者大多为溶骨性骨质破坏,占97.2%,多呈"虫噬样",可见骨骼呈膨胀样改变,成骨性改变极少出现,且占2.8%;骨转移瘤患者溶骨性骨质破坏占74.0%,呈"局灶性"表现多见,成骨性改变占26.0%。MM患者溶骨性骨质破坏明显高于骨转移瘤患者(χ2=14.757,P<0.05)。MM的SUVmax明显低于骨转移瘤患者(4.25±2.16 vs 7.84±3.25)(t=6.830,P<0.05)。MM对18F-FDG多表现为弥漫性轻微摄取,骨转移瘤对18F-FDG多表现为不均匀高摄取,差异有统计学意义(P<0.05)。结论:18F-FDG PET/CT检查有助于获取骨质结构和代谢变化的影像学特征,对MM和骨转移瘤的鉴别诊断具有重要临床应用价值。
Objective:To investigate the imaging characteristics of 18F-FDG positron emission computed tomography(18F-FDG PET/CT)in multiple myeloma(MM)patients and to analyze its application value in MM and bone metastases.Methods:A retrospective analysis was made on MM patients(n=72)and bone metastases patients(n=50)admitted to Hainan Western Central Hospital from January 2017 to March 2019.All patients underwent 18F-FDG PET/CT examination.The distribution of lesions,bone destruction,maximum standardized uptake(SUVmax)and metabolic homogeneity were analyzed in both groups.Results:More than 80%of MM and bone metastases involved thoracic bone,spine and pelvis,followed by limbs.MM was more common in the lesions of thoracic bone and skull than those in bone metastases,the difference was statistically significant(P<0.05).The majority of MM patients presented osteolytic bone destruction(97.2%),mostly showing"insect-like phagocytic pattern",so the bone showed dilated changes,and osteogenic changes were rarely seen(2.8%).Osteolytic bone destruction accounted for 74.0%in patients with bone metastatic tumor,presenting"focal"appearance more often,and osteogenic changes accounted for 26.0%.Osteolytic bone destruction in patients with MM was significantly higher than that in patients with bone metastases(χ2=14.757,P<0.05).The SUVmax of MM(4.25±2.16)was significantly lower than that of bone metastases(7.84±3.25)(t=6.830,P<0.05).Diffuse mild uptake of 18F-FDG was more common in patients with MM,and heterogeneous high uptake of 18F-FDG was more common in patients with bone metastasis,the difference was statistically significant(P<0.05).Conclusion:18F-FDG PET/CT examination is helpful to acquire the imaging features of bone structure and metabolic changes,and shows an important clinical value in the differential diagnosis of MM and bone metastases.
作者
郑庆中
苏洁敏
李小玲
陈壮军
王盛智
曾勇
ZHENG Qing-Zhong;SU Jie-Min;LI Xiao-Ling;CHEN Zhuang-Jun;WANG Sheng-Zhi;ZENG Yong(Department of Radiology,Hainan West Central Hospital,Danzhou 571799,Hainan Province,China)
出处
《中国实验血液学杂志》
CAS
CSCD
北大核心
2020年第4期1267-1271,共5页
Journal of Experimental Hematology
基金
海南省医学科研基金资助(16A200625)。
