不同类型原发性前纵隔肿瘤18氟-氟代脱氧葡萄糖PET/CT显像特征对比分析

18F-fluorodeoxyglucose PET/CT imaging features of primary anterior mediastinal tumors of different types:a comparative analysis

目的探讨原发性前纵隔肿瘤18氟-氟代脱氧葡萄糖PET/CT(18F-FDG PET/CT)的显像特征。方法回顾性分析27例经病理证实为原发性前纵隔肿瘤患者(侵蚀性胸腺瘤8例,胸腺癌5例,非典型类癌1例,霍奇金淋巴瘤7例,非霍奇金淋巴瘤6例)的18F-FDG PET/CT影像资料,分析不同类型前纵隔肿瘤的18F-FDG PET/CT影像学特征,并比较侵蚀性胸腺瘤、胸腺癌、非霍奇金淋巴瘤和霍奇金淋巴瘤的最大径、最大标准摄取值(SUVmax)及发病年龄。结果侵蚀性胸腺瘤、胸腺癌和不典型类癌18F-FDG PET/CT显像多表现为前纵隔内不规则肿块影,密度不均匀;淋巴瘤18F-FDG PET/CT显像多表现为纵隔内多个肿大淋巴结融合成团块状,常跨区生长。侵蚀性胸腺瘤、胸腺癌、非霍奇金淋巴瘤和霍奇金淋巴瘤的最大径比较,差异无统计学意义(P>0.05);侵蚀性胸腺瘤的SUVmax低于胸腺癌(P<0.05);霍奇金淋巴瘤患者的发病年龄均低于侵蚀性胸腺瘤、胸腺癌(均P<0.05)。结论不同类型原发性前纵隔肿瘤的18F-FDG PET/CT显像各有一定的特征性表现,结合患者临床表现多能对其做出准确诊断。

Objective To explore the 18F-fluorodeoxyglucose PET/CT(18F-FDG PET/CT) imaging features of primary anterior mediastinal tumors.Methods The 18F-FDG PET/CT image data of 27 patients with primary anterior mediastinal tumors(8 cases of aggressive thymoma,5 of thymic carcinoma,1 of atypical carcinoid,7 of Hodgkin′s lymphoma,and 6 of non-Hodgkin′s lymphoma) confirmed by pathology were retrospectively analyzed,the 18F-FDG PET/CT imaging features of anterior mediastinal tumors of different types were analyzed,and maximum diameter,maximum standard uptake value(SUVmax),and age of disease onset were compared among aggressive thymoma,thymic carcinoma,non-Hodgkin′s lymphoma and Hodgkin′s lymphoma.Results The 18F-FDG PET/CT images of aggressive thymoma,thymic carcinoma and atypical carcinoid were commonly featured by irregular mass with heterogeneous density in anterior mediastinum;on 18F-FDG PET/CT imaging,lymphoma mainly exhibited the mass fused by multiple enlarged lymph nodes in the mediastinum,commonly growing interregionally.There was no statistically significant difference in maximum diameter among aggressive thymoma,thymic carcinoma,non-Hodgkin′s lymphoma and Hodgkin′s lymphoma(P>0.05);aggressive thymoma had a lower SUVmax than thymic carcinoma(P<0.05);patients with Hodgkin′s lymphoma reported lower age of disease onset than aggressive thymoma and thymic carcinoma(all P<0.05).Conclusion Primary anterior mediastinal tumors of different types exhibit specific characteristic manifestations on 18F-FDG PET/CT imaging,and accurate diagnosis can usually be achieved in combination with patients′ clinical manifestations.