^(18)F-DG PET显像在恶性淋巴瘤诊断和分期中的价值

Utility of ^(18) F-DG PET in diagnosis and staging of lymphoma

目的 探讨18F 脱氧葡萄糖 (FDG)PET显像对恶性淋巴瘤诊断和分期的价值。方法 对 2 7例疑诊为淋巴瘤并进行18F DGPET显像的患者进行回顾性研究 ,对比最后诊断 (以病理检查作为判断依据 ) ,计算诊断符合率。确诊的 19例初发或复发淋巴瘤 ,按淋巴结区、结外区和骨 /骨髓 3个解剖区评价18F DGPET对淋巴瘤浸润病灶的检出率。结果 2 7例疑诊淋巴瘤患者中 ,18F DGPET检查结果与最后诊断符合率为 92 .6 % (2 5 /2 7)。在淋巴瘤病灶检测中敏感性为 89.7% (6 1/ 6 8) ,特异性为 95 .5 % (472 / 494)。淋巴结区和结外区的敏感性、特异性分别为 88.1%和 99.4%、91.7%和 83 .6 %。 2例弥漫性骨髓浸润18F DGPET均检出。并有 2例患者分期从ⅢB提高到IVB。结论 18F DGPET显像可以为恶性淋巴瘤特别是以长期发热为主要表现的淋巴瘤的鉴别诊断提供重要依据。分期诊断中 ,18F DGPET对淋巴瘤病灶有较高的敏感性、特异性 。

Objective To evaluate the effectiveness of fluorine 18 Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) in the detection and staging of malignant lymphoma. Methods 27 patients with suspected lymphoma underwent 18 F DG PET examination. The results were compared with the final diagnosis (biopsy) and the diagnostic accuracy of the 18 F DG PET examinations was assessed. Among 19 patients with primary lymphoma, three anatomic regions (lymph nodes, extranodal regions and bone/bone marrow) were selected to evaluate the accuracy of 18 F DG PET in detection of lymphomatosis infiltration. The lesional biopsy, bone marrow aspiration or clinical follow up data were used for confirmation. Results Among 27 patients mentioned above, the 18 F DG PET diagnosis was correct in 25 patients (92.6%). there were two false positive 18 F DG PET findings. In 19 patients with diagnosis of lymphoma, the 18 F DG PET detected 61 lesions in 68 verified lesions, 7 false negative and 22 false positive. The sensitivity was 89.7% and the specificity was 95.5%. The sensitivity and specificity in lymph nodes and extranodal regions were 88.1% and 99.4%, 91.7% and 83.6% respectively. Two cases of diffuse marrow infiltration were detected by 18 F DG PET examinations. There were two cases upstaged from IIIB to IVB after the PET findings. Conclusion Noninvasive 18 F DG PET is useful in differential diagnosis of lymphoma. And it has relatively high sensitivity and specificity in detection of lymphomatosis lesions for more accurate staging.