结节病^(18)F-脱氧葡萄糖PET/CT影像学表现

^(18)F-FDG PET/CT findings of sarcoidosis

目的总结结节病的18F-脱氧葡萄糖正电子发射计算机断层显像(^(18)F-deoxyglucose positron emission tomography with CT,18F-FDG PET/CT)表现。方法回顾性分析经组织病理和临床随访证实的40例结节病患者的^(18)F-FDG PET/CT影像资料。结果 40例^(18)F-FDG PET/CT影像均有纵隔淋巴结肿大,34例双肺门淋巴结肿大,6例右侧肺门淋巴结肿大;肿大淋巴结位于JACC-UICC标准分区4R区40例,10R区40例,7区34例,10L区30例,5区24例;胸内肿大淋巴结呈圆形或椭圆形,形态规则,边界清晰,密度均匀,CT值24.0~57.6(34.1±8.5)Hu,淋巴结最大标准摄取值(maximum standardized uptake value,SUVmax)5.4~28.2(20.8±6.2);淋巴结内见轻度钙化2例,未见明显融合、坏死及侵犯血管;36例见肺部结节,结节SUVmax 1.8~6.5(4.4±1.9),支气管血管束增粗32例,结节沿支气管血管束及胸膜下分布22例,肺内磨玻璃影6例,胸膜增厚或胸腔积液26例;有腹盆腔淋巴结肿大26例,皮下结节或肌间软组织受累20例,脾脏受累4例,双膝关节受累2例。结论结节病^(18)F-FDG PET/CT表现具有一定特征性,^(18)F-FDG PET/CT在结节病诊断中有较高价值。

Objective To analyze the 18F-deoxyglucose positron emission tomography/CT （18 F-FDG PET/CT） findings of sarcoidosis. Methods The 18 F-FDG PET/CT findings were retrospectively analyzed in 40 patients with pathologically and clinically confirmed sarcoidosis. Results The enlarged mediastinai lymph nodes were found in all cases, in which 34 cases were found bilateral enlarged hilar lymph nodes and 6 cases were found unilateral right enlarged hilar lymph nodes. According to the JACC-UICC standard partitions, all enlarged lymph modes were located at 4R （40 cases）, 10R （40 cases）, 7 （34 cases）, 10L （30 cases） and 5 （24 cases）. The enlarged thoracic lymph nodes were in round or oval shape, with smooth boundary and homogeneous density. The CT value was from 24. 0 to 57.6 （34. 1± 8. 5） Hu, and the maximum standardized uptake value （SUVmax） of lymph nodes was from 5.4 to 28.2 （20.8±6.2）. Slight calcification was found in 2 cases, with no obvious fusion, necrosis or invasion of blood vessels. The lung nodules were involved in 36 cases and the SUVmax was from 1.8 to 6.5 （4.4±1.9）. The thickening of the bronchovascular bundle was found in 32 cases, the nodules were distributed around the bronchovascular bundle and subpleural in 22 cases, the ground-glass opacity was found in 6, the pleural thickening or pleural effusion were found in 26, enlarged abdominal-pelvic lymph nodes were found in 26, the subcutaneous nodules or soft tissue between muscle were found in 20, the spleen was involved in 4, and the both knee joints were involved in 2 cases. Conclusion Sarcoidosis has some 18F-FDG PET/CT characteristics, which has a great value to the diagnosis of sarcoidosis.