恶性肿瘤骨骼肌转移的PET-CT诊断价值分析

PET-CT evaluation of skeletal muscle metastases originated from primary malignancies

目的分析骨骼肌转移灶的PET-CT影像特征,并评价其诊断价值。方法回顾性分析自2006年8月至2009年11月在我院经PET-CT全身扫描疑诊恶性病变患者的影像表现与临床资料。检查范围通常为颅顶至股骨中段,少数患者扩大至膝关节下或足底部。PET-CT诊断结果经穿刺活检,其他影像方法及临床随访证实。结果 PET-CT研究证实,2413例受检者中有恶性病变824例,而在这824例中有骨髂肌转移者12例,占恶性肿瘤患者的1.46%,12例包括单发7例和多发5例,共有26处转移灶。骨髂肌转移灶PET显像阳性,均表现为高SUV值,而CT则无特征性表现。本组骨髂肌转移绝大多数来自肺癌（9/12）。8例患者继PET-CT诊断为骨骼肌转移后8~130d内病死（平均64.5d）。结论 PET-CT可作为无创性诊断恶性肿瘤骨骼肌转移和提高其检出率的有效方法。

Objective To analyze positron emission tomography-computed tomography （PET-CT） imaging features of the skeletal muscle metastases （SMM） and to evaluate their value for the diagnosis. Methods Imaging findings and clinical data of 2 413 patients with clinically suspected malignancies and underwent whole-body scans of PET-CT from August 2006 to November 2009 in our hospital were analyzed retrospectively and the results of PET-CT were confirmed by puncture biopsy, other imaging modalities and clinical follow-up. PET-CT inspection scope usually was from the carvarium to middle segment of the femur but in few patients it was extended to knee joint inferior or oven to foot bottom. Results PET-CT study demonstrated that there were 824 malignant tumor patients in 2413 cases, while in these 824 patients, 12 cases were SMM, who accounted for 1.46% of malignant tumor patients, of whom, 7 cases appeared as single focus and 5 cases appeared as multiple foci, all SMM foci distributed in 26 sites. On PET SMM foci were positive and appeared high SUV but CT was not specific manifestation. The most SMM in the group originated from lung cancer （9/12）. Following SMM diagnosed by PET-CT, 8 patients died within 8-130 days （average： 64.5 days）. Conclusion PET-CT can be taken as a noninvasive and effective-modality for detecting SMM from malignancies and elevating the detection rate.