^(18)F-FDGPET/CT诊断腹膜后纤维化

^(18)F-FDG PET/CT in diagnosis of retroperitoneal fibrosis

目的探讨^(18 )F-FDG PET/CT诊断腹膜后纤维化(RPF)的价值。方法回顾性分析因RPF接受^(18 )F-FDG PET/CT检查的12例患者,分析其病灶形态、分布范围和葡萄糖代谢活性最大标准摄取比值(SUV_(max))。结果 12例患者中,7例为初诊患者,5例为治疗后患者。7例初诊RPF患者中4例为继发性,病因分别为IgG4相关疾病、乳腺癌和前列腺癌。12例患者均可见腹主动脉和/或髂血管旁软组织密度病灶,91.67%(11/12)患者可见输尿管受累。初诊RPF患者腹膜后病灶SUV_(max)(4.21±1.76)显著高于治疗后患者(1.46±0.25;P<0.05)。依据PET/CT检查结果,3例有代谢活性病灶的特发RPF患者接受激素和/或他莫昔芬等免疫抑制治疗,4例具有活性病灶的继发RPF患者接受针对病因治疗;5例治疗后患者,3例继续当前激素维持剂量治疗,2例未接受其他治疗。结论 PET/CT可用于评价RPF病灶活性和分布范围。

Objective To explore the value of 18F-FDG PET/CT in diagnosis of retroperitoneal fibrosis （RPF）.Methods Totally 12 RPF patients underwent 18F-FDG PET/CT scanning, and the characteristics of metabolic activity, distribution of retroperitoneal lesions and maximum standardized uptake value （SUVmax） were analyzed retrospectively.Results Among 12 patients, 7 were initial evaluation patients, 5 were post-treatment patients. Of 7 initial evaluation patients, there were 4 patients with secondary RPF, including prostate carcinoma, breast cancer and IgG4-related disease. Retroperitoneal mass isodense with muscle surrounding the abdominal aorta or the iliac arteries were found in 12 patients, and ureteral involvement were found in 11 paients （11/12, 91.67%）. SUVmax in initial evaluation patients （4.21±1.76） was higher than that in patients after treatment （1.46±0.25, P〈0.05）. According to PET/CT, 3 idiopathic RPF patients as initial evaluation with high metabolic activity lesions received immunosuppressive therapy including corticosteroids and tamoxifen, and 4 secondary RPF patients with high metabolic activity lesions received treatment based on causes. Among 5 post-treatment patients, 3 continued to accept current corticosteroids maintenance dose, while 2 did not receive any other treatment.Conclusion PET/CT may be used to evaluate the activity and extension of lesions in patients with RPF.