胃恶性淋巴瘤的^(18)F-FDG PET/CT表现与鉴别诊断

Diagnosis and differentiation with ^(18)F-FDG PET/CT in gastric lymphoma

目的:分析胃淋巴瘤的18F-FDG PET/CT影像学特点,探讨其在胃淋巴瘤的诊断、鉴别诊断和病情评估中的价值。方法:17例经胃镜活检病理证实的胃淋巴瘤患者,包括13例弥漫性大B细胞淋巴瘤,3例粘膜相关淋巴组织B细胞淋巴瘤和1例NK/T细胞淋巴瘤,均在治疗前行PET/CT显像。结果:胃淋巴瘤的PET/CT表现以不同形式的胃壁增厚和显著增高的FDG代谢为主要特征,6例呈Ⅰ型表现(胃壁弥漫性增厚伴FDG代谢显著增高),7例呈Ⅱ型表现(胃壁节段性增厚伴FDG代谢显著增高),3例呈Ⅲ型表现(胃壁局限性增厚伴FDG代谢增高),1例呈Ⅳ型表现(胃壁多发结节样增厚伴FDG代谢串珠样增高);PET/CT评价4例仅累及胃壁,3例累及胃壁和淋巴结,10例累及胃壁、淋巴结和其它脏器。结论:胃淋巴瘤的18F-FDG PET/CT表现以Ⅰ型和Ⅱ型更为多见;18F-FDG PET/CT有助于淋巴瘤的诊断和病情全面评估。

Objective：The imaging characteristic of 18F-FDG PET/CT in patients with gastric lymphoma were investigated.The aim of this study was to approach the adequacy of PET/CT in diagnosis,differentiation and evaluating patient＇s condition of gastric lymphoma.Methods：Seventeen newly diagnosed patients（13 males and 4 females,age 22~79 years） with gastric lymphoma underwent 18F-fluorodeoxyglucose（FDG） PET/CT examination before treatment.These all lesions were histopathologically confirmed by endoscope,including 13 cases of diffused large B cell lymphoma（DLBCL）,3 cases of mucosa associated lymphoid tissue lymphoma（MALT） and 1 case of NK/T cell lymphoma.Results：The PET/CT findings of gastric lymphoma showed the characteristic of diverse thickened gastric wall with significantly high FDG uptake.There were 6 in typeⅠ（diffuse thickened gastric wall with significantly high FDG uptake）,7 in type Ⅱ（segmental thickened gastric wall with significantly high FDG uptake）,3 in type Ⅲ（local thickened gastric wall with high FDG uptake） and 1 in type Ⅳ（multiple nodular thickened gastric wall with string-of-beads high FDG uptake）.On PET/CT images of the seventeen patients,4 cases displayed only stomach involvement,3 cases extra-lymph nodes involvement,10 cases extra lymph nodes and organs involvement.Conclusion：TypeⅠ and type Ⅱ findings of PET/CT are more often seen in gastric lymphoma.PET/CT is favorable to its diagnosis and overall assessment before treatment.