^(18)F-FDG PET/CT显像在诊断多发性骨髓瘤骨病变中的价值

Diagnosis value of ^(18)F-FDG PET/CT in multiple myeloma bone disease

目的探讨18F-FDG PET/CT显像在诊断多发性骨髓瘤骨骼病变中的应用价值。方法回顾性分析16例行18F-FDG PET/CT全身显像的经骨髓穿刺或病理活检证实的多发性骨髓瘤患者的临床资料。结果 16例患者全身骨骼18F-FDG PET/CT检查中,1例呈阴性,15例检出多发阳性病灶(标准摄取最大值SUVmax 3.4~13.8,标准摄取平均值SUVave 2.0~11.5)。在检出呈阳性的15例中,共显示骨髓瘤病灶211处,其中PET有172处表现为18F-FDG摄取增高(占81.5%),同机CT检出呈虫蛀状、颗粒状、穿凿样溶骨性改变病灶185处(占87.7%)。PET和CT同时检出病灶为146处(占69.1%),表现为相匹配的18F-FDG高摄取灶及溶骨性病变;PET检出而同机CT未检出病灶26处(占12.3%),表现为18F-FDG在病灶摄取增高而CT未见异常;同机CT检出而PET未检出病灶39处(占18.5%),病灶表现为小灶状骨质破坏区而未见18F FDG高摄取。结论 18F-FDG PET/CT对于多发性骨髓瘤的诊断和病变累及范围具有较高的价值,对临床分期、治疗及疗效评价有一定帮助。

Objective To investigate the diagnostic value of PET/CT imaging methods in multiple myeloma bone disease. Methods The clinical data were analyzed retrospectively in 16 pa- tients with multiple myeloma diagnosed by bone marrow aspiration or biopsy on 18 fluoro deoxyglu- cose PET/CT imaging. Results Sixteen cases were examined by bone 18F-FDG PET/CT, with 1 negative case and 15 cases with multiple lesions. （The maximum standard uptake value SUVmax ranged from 3.4 to 13.8, the average standard uptake value SUVave ranged from 2.0 to 11.5）. In the positive 15 cases, 211 bone marrow lesions were found. Among them, 172 lesions showed in- creased uptake of 18F-FDG PET/CT （81.5 % ）, and the shape of lesions were moth like, granular, punched out lyric changes in 185 （87.7%）. Lesions detected by both PET and CT were 146 （69. 1% ）, which showed high uptake on lSF-FDG matching with osteolytic lesions. 26（ 12.3 % ） lesions were detected by PET, the standard uptake value increased in lSF-FDG whereas no abnormality were seen in CT. On the other hand, 39 （ 18.5 % ） lesions were detected by CT, which showed small focal bone destruction zone instead of no 18F-FDG high uptake. Conclusion 18 F-FDG PET/CT is of high value in the diagnosis and the lesion extent of multiple myeloma, and it is of cer- tain help in clinical staging, treatment and curative assessment.