鼻咽癌患者放射性骨坏死引起的正电子显像假阳性结果1例及文献复习

A case report of false positive F-18-FDG PET finding caused by osteoradionecrosis in a nasopharyngeal carcinoma patient and review of literatures

目的:探讨鼻咽癌(NPC)患者放射性骨坏死(osteoradionecrosis,ORN)引起正电子假阳性结果的原因及避免因此引发诊断错误的方法。方法:回顾性分析1例放疗后的鼻咽癌患者,行鼻咽部MRI及正电子显像后,再行组织病理学检查,对三种结果进行分析、比较。结果:MRI及正电子显像均诊断患者颅底区域肿瘤复发,组织病理学结果则显示鼻咽部病灶为放射性骨坏死。因此正电子扫描结果为假阳性结果。结论:鼻咽癌患者放疗后所致的放射性骨坏死容易引起正电子显像假阳性结果并可能引发不必要的治疗,因此NPC患者的正电子图像,对于可能的局限性肿瘤复发诊断,应该非常慎重。

Objective：To explore the reason of false positive F - 18 - FDG PET finding caused by osteoradionecro- sis（ORN） in a nasopharyngeal carcinoma（NPC） patient and the means of avoiding misdiagnosis. Methods： A NPC patient after radiotherapy was retrospectively analyzed, receiving a histopathologieal examine after having an FDG PET and MRI scan in his nasopharynx. Tow results were analyzed and compared. Results： Tumour recurred at the skull base found in both MR1 and FDG PET scan. But the histopathological studies showed ORN. Conclusion： ORN caused by radiotherapy results in false positive F - 18 - FDG PET finding easily,and this finding usually leads to un- necessary treatment. Therefore, the FDG PET images in NPC patients with possible local recurrence should be diagnosed carefully.