摘要
目的:分析多发性骨髓瘤(MM)的18F-FDG PET/CT影像表现,探讨PET/CT对MM的鉴别诊断及疗效评估价值。方法:回顾性分析近3年来我院经病理证实的22例MM患者的PET/CT影像资料,包括男13例,女9例。其中5例有治疗后多次PET/CT随访影像资料。结果:22例均为多发骨病灶,合并病理骨折11例38处病灶。PET/CT表现为弥漫性或多发穿凿样骨破坏,骨破坏不明显时可仅表现为髓腔密度增高;少数骨病灶可有膨胀性表现,骨皮质穿破后可形成软组织肿块;全身骨病灶代谢不均匀增高,SUVmax=5.6±2.3;病理骨折处SUVmax=4.9±0.7;骨破坏区和代谢增高区可不一致;治疗后MM病灶代谢程度降低,PET所见变化早于CT形态变化;病理骨折处代谢增高,需和肿瘤活性残留相鉴别。结论:PET/CT有助于MM的鉴别诊断并早期评价病灶的疗效反应,具有重要临床应用价值。
Purpose： To explore the differential diagnostic value and the curative effect evaluation value for multiple myeloma with 18F-FDG PET/CT.Methods：Twenty-two cases of multiple myeloma which were examed with 18F-FDG PET/CT and confirmed by pathology in the last 3 years were retrospectively analyzed.There were 13 male and 9 female.Five of them had follow-up examinations with 18F-FDG PET/CT.Results： All of the cases had multiple lesions and 11 of them had 38 lesions combined with pathological fracture.PET/CT findings： multiple or diffusive bone destructions with worm-eaten like or maybe just increase in density without obvious bone destructions in cavum medullare were found on PET/CT.There was bone expansion in a few lesions,and soft tissue mass around the bone destructions when the bone cortex was broken through.All lesions were hypermetabolism in different degree that the maximum of standard uptake value（SUVmax） was 5.6±2.3, and the pathological fracture were SUVmax=4.9±0.7.The bone destructions may not match with the hypermetabolism.MM should be differential diagnosed from metastatic tumor of bone,osteoporosis and medullary actively hyperplasia.The lesions＇ metabolism decreased after treatment and the change of metabolism was ahead of morphology.The hypermetabolism of pathological fracture in reconstruction phase must be differentiated from residual activity of tumor.Conclusions：There is significant clinical value that contributing to differential diagnosis and early curative effect evaluation of multiple myeloma with 18F-FDG PET/CT.
出处
《中国医学计算机成像杂志》
CSCD
北大核心
2011年第1期70-74,共5页
Chinese Computed Medical Imaging
