PET/CT应用于恶性淋巴瘤诊治中的临床价值

Clinical value of PET/CT applied in diagnosis and treatment of malignant lymphoma

目的 探讨正电子发射型计算机断层显像（PET/CT）在恶性淋巴瘤诊断、临床价值、疗效评价及残留病灶诊断中的临床价值。方法 收集云南省肿瘤医院2008年1月至2013年12月经PET/CT检查考虑为恶性淋巴瘤的患者153例,根据不同的研究目的筛选病例并进行分组和统计分析。结果PET/CT检查诊断阳性率为96.08%（147/153）;确诊恶性淋巴瘤患者PET/CT检查的标准摄取值的最大值（SUVmax）为9.26-10.94,标准摄取值的平均值（ΔSUV值）为7.54-8.95;非霍奇金淋巴瘤组ΔSUV值高于霍奇金淋巴瘤组,但差异无统计学意义（P〈0.05）;治疗前进行PET/CT、CT结合超声检查,52例患者中16例经PET/CT检查后调整了CT结合超声检查的临床分期;治疗前后ΔSUV值比较,差异有统计学意义（P〈0.05）。治疗前后均进行PET/CT检查评估疗效34例,二者疗效判断一致21例,不一致13例。结论 在恶性淋巴瘤中,PET/CT检查诊断阳性率高,可作为临床诊断淋巴瘤较为可靠的影像学依据;SUV值是PET/CT检查中一项重要指标;PET/CT检查是恶性淋巴瘤临床分期及疗效评价的重要检查手段,不但可以通过病灶大小的变化判断疗效,而且能通过SUV值评估残留病灶的代谢情况,指导临床制订合理的治疗方案。

Objective To investigate the clinical value of PET/CT in the diagnosis, clinical value, curative effect evaluation and residual lesion diagnosis of malignant lymphoma （ML）. Methods Ono hundred and fifty-three cases of ML considered by PET/CT examination in the Yunnan Provincial Tumor Hospital from January 2008 to December 2013 were collected, screened according to different research purposes, grouped and statistically analyzed. Results The diagnosis positive rate of PET/CT was 96.08% （147/153）. The maximal PET/CT standard uptake value （SUVmax） for diagnosing ML was 9.26-10.94,the mean SUV （ASUV） was 7.54-8.95. ASUV in the non-Hopdgkin lympghoma （NHL） group was higher than that in the Hodgkin lymphoma （HL） group, but the difference was not statistically significant （P〈0.05） ;in 52 cases of preoperative PET/CT and CT combined with ultrasound examination, the clinical stage by CT combined with ultrasound examination in 16 cases were adjusted after PET/ CT examination ; ASUV had statistical difference between before and after treatment （P〈0.05） ;in 34 cases of preoperative and postoperative PET/CT examination for evaluating the curative effects, their curative effect judgments were consistent in 21 cases and inconsistent in 13 cases. Conclusion The PET/CT examination has high positive rate for diagnosing ML and may serve as a reliable imagiological basis for clinically diagnosing lymphoma;the SUV value is an important indicator in the PET/CT examination; the PET/CT examination is an important means of the clinical staging and curative effect evaluation of ML, which is not only used to judge the curative effect by the lesion size,but also to assess the metabolic condition of residual lesion by the SUV value for guiding clinic to formulate the rational treatment scheme.