正电子发射型计算机断层扫描/计算机体层扫描在恶性淋巴瘤临床分期中的初步应用

Preliminary application of positron emission tomography/computed tomography on the staging of malignant lymphoma

目的:观察氟去氧葡萄糖(FDG)正电子发射型计算机断层扫描/计算机体层扫描(PET/CT)显像和传统分期检查方法对恶性淋巴瘤分期和治疗后再分期的影响,以探讨其临床应用价值。方法:采用视觉分析和半定量分析相结合的方法,比较42例病理确诊为恶性淋巴瘤患者传统分期检查和PET/CT对分期和治疗后再分期的符合率,以及对淋巴结区和结外病灶检出率的差异。结果:PET/CT检查与传统分期手段对分期判断的符合率分别为95.2%(40/42)和78.6%(33/42)。对淋巴结内病灶传统分期检查的检出率为88.2%(60/68),PET/CT为97.1%(66/68),两者间差异有显著性意义(P<0.05);对淋巴结外病灶传统分期检查的检出率为58.3%(14/24),PET/CT为91.7%(22/24),两者间差异有极显著性意义(P<0.01)。PET/CT检查使TNM分期改变者9例,达21.4%,其中分期升高7例,下降2例,8例(19.0%)的治疗计划发生改变。结论:FDG PET/CT可提高恶性淋巴瘤的分期和再分期的准确率,并可提高淋巴结内外病变的检出率,这有利于更准确地制订治疗方案和预测预后。

Objective ：Position emission tomography/computed tomography （PET/CT） is a new bio-imaging system which is combined metabolic with anatomic imaging. This study was to compare the accuracy of conventional staging methods （including computed tomography, ultrasound, magnetic resonance imaging, and detection of bone marrow ） with that of PET/CT for lymphoma staging and re-staging. Methods：A total of 42 patients with lymphoma diagnosed by operation or biopsy, received conventional and PET/CT staging. The accuracy of these two methods and their impact on lymphoma staging were compared. Results：The accuracy of PET/CT scan was 95.2% （40/42） ,and that of conventional staging was 78.6% （33/42）. The detection rates of internal lymph node were 97. 1% （66/68） and 88.2% （60/68）, respectively. The detection rates of outer lymph node were 91. 7% （22/24） and 58. 3% （ 14/24）, respectively. Compared with conventional staging methods , 7 cases were up-staged and 2 cases were down-staged by PET/CT, which led to the change of therapy in 8 cases. Conclusion：PET/CT scan is more sensitive and accurate than conventional staging methods in staging and restaging of lymphoma.