18F-FDGPET／CT对继发性周围神经恶性病变的诊断价值

The value of 18F-FDG PET/CT in the diagnosis of secondary malignant peripheral nerve lesion

目的 总结继发性周围神经恶性病变18F-脱氧葡萄糖（FDG）PET／CT影像特征，探讨18F—FDGPET／CT在继发性周围神经恶性病变中的应用价值。方法回顾性分析经病理检查或长期随访证实的8例周围神经恶性病变患者18F-FDGPET／CT影像学资料，比较继发性周围神经恶性病变与健侧周围神经PET／CT表现的异同，利用SPSS10．0软件对受累的周围神经及健侧对应部位周围神经的最大标准摄取值（SUVmax）行配对t检验。结果8例继发性周围神经恶性病变患者共发现病灶12个，PET示病灶均沿神经束或椎间孔走行，且表现为束条形、根块状或结节状FDG代谢异常增高，SUVmax为6．86±3．87，同机CT病灶表现为沿神经束或神经根管走行之束条形、根块状或结节状软组织密度影，病灶均与周围软组织及邻近脂肪间隙分界不清；健侧对应部位周围神经在18F—FDGPET及同机CT上均未见明确显影，其SUVmax为1．10±0．46；继发性周围神经恶性病变与健侧周围神经SUVmax比较，差异有统计学意义（t=9．231，P〈0．001）。结论18F—FDGPET／CT可以准确反映肿瘤对周围神经的侵犯及转移，显示病灶的大小、形态、分布及肿瘤活性，对继发性周围神经恶性病变的诊断具有重要价值。

Objective To investigate the characteristics and diagnostic value of 18F-fluorodeoxyglucose （FDG） PET/CT in patients with secondary malignant peripheral nerve lesions. Methods is F-FDG PET/CT studies of 8 cases of secondary malignant peripheral nerve lesions confirmed by histopathology or follow-up were analyzed retrospectively. The maximum standardized uptake value （ SUVmax ） of infiltrating peripheral nerves and contralateral normal peripheral nerves was measured and compared with their morphological appearances on CT. Paired student t-test was performed by SPSS 10.0. Results Twelve secondary malignant peripheral nerve lesions with high ISF-FDG metabolism were found in 8 cases. On PET imaging, the lesions distributed along the neurovascular tissues or intervertebral foramina with appearances resembling those of fibre bundles, radices or nodes on PET but no density differences with the surrounding soft tissue or fat planes on CT. The SUVmax was 6.86 ± 3.87. The contralateral normal peripheral nerves showed no abnormal 18F-FDG uptake with a SUVmax of 1. 10 ± 0.46, which was significantly different from that of the secondary malignant peripheral nerve lesions （ t = 9.231, P 〈 0. 001 ）. Conclusion 18F-FDG PET/CT may be useful in locating the secondary malignant peripheral nerve lesions and in assessing its regional infiltration.