^(18)氟-脱氧葡萄糖PET/CT对原发灶不明的骨转移瘤的诊断作用

Application of ^(18)F-FDG PET/CT in diagnosis of bone metastases of unknown primary tumor

目的探讨^(18)氟-脱氧葡萄糖PET/CT在原发灶不明的骨转移瘤(BMUPT)患者中的应用价值,并总结BMUPT患者PET/CT图像特征。方法回顾性分析本院PET/CT中心检查的49例原发灶不明的骨转移瘤患者的影像资料,记录其原发灶部位、淋巴结转移、远处脏器转移、骨转移部位及骨转移性质,同时测定各骨转移灶最大标准化摄取值(SUV_(max)),对不同骨转移性质及部位的SUV_(max)做统计学分析。结果 PET/CT检查共正确检出48例原发灶,有1例未正确检出,新发现42例合并淋巴结转移,26例合并器官转移。49例患者中成骨性转移9例,溶骨性转移33例,混合性转移7例。各部位骨转移发生率依次为:脊柱91.8%、骨盆85.7%、胸部77.5%、四肢57.1%、颅骨24.4%。溶骨性转移SUV_(max)大于成骨性转移(t=3.55,P<0.05)。成骨性转移、溶骨性转移各部位之间SUV_(max)差异均无统计学意义(P>0.05)。结论 PET/CT在BMUPT的原发灶寻找中具有很高的准确性,且能发现新的淋巴结及远处转移灶,可以BMUPT患者病情评估及综合治疗提供更全面的价值。

Objective To investigate the clinical value of 18F-fluorodeoxyglucose（18F-FDG） positron emission tomography/computed tomography（PET/CT） in diagnosis of bone metastases of unknown primary tumor（BMUPT）, and summarize the features of PET/CT findings in patients with BMUPT. Methods The imaging data of 49 patients with BMUPT in our hospital were retrospectively analyzed. Primary tumor sites, lymph nodes metastases, organ metastases and bone metastases were recorded. The maximum standardized uptake value（SUVmax） of each bone metastasis were determined and the SUVmax of different bone metastases properties and metastases sites were statistically analyzed. Results Forty-eight cases of primary tumor were correctly detected by PET/CT, 1 case was not correctly detected. 42 cases were newly found with lymph nodes metastases and 26 cases were found with organ metastasis. Among the 49 patients, there were 9 cases of osteogenic metastases, 33 cases of osteolytic metastases and 7 cases of mixed metastases.Incidence of bone metastasis in each place was spine〉pelvis〉chest〉limbs〉skull. The SUVmax of osteolytic metastases was higher than that of osteogenic metastases（t=3.55, P〈0.05）. Differences of SUVmax between osteogenic and osteolytic metastasis at the sites of bone metastases was not significant（P〉0.05）. Conclusion PET/CT has a high accuracy in diagnosis for a primary tumor of BMUPT.It can find new lymph nodes and organ metastases, which provides more comprehensive value for the evaluation and treatment of BMUPT patients.