18氟-氟代脱氧葡萄糖PET/CT对多系统结节病和淋巴瘤的鉴别诊断

Differential diagnosis of multisystem sarcoidosis and lymphoma using 18F-fluorodeoxyglucose positron-emission tomography/computed tomography

目的探讨18氟-氟代脱氧葡萄糖(18F-FDG)PET/CT检查在多系统结节病和淋巴瘤鉴别诊断中的价值。方法回顾性分析2009年6月~2018年5月我院收治的15例结节病患者和20例淋巴瘤患者的18F-FDG PET/CT图像,所有病例均经病理证实。记录两组患者的最大淋巴结大小、淋巴结的最大SUV值、两侧肺门淋巴结是否对称性肿大及肿大淋巴结的融合、坏死、钙化情况。结果两组的淋巴结最大SUV值、淋巴结钙化率、淋巴结坏死率比较,差异无统计学意义(P>0.05);结节病组的最大淋巴结直径小于淋巴瘤组,差异有统计学意义(P=0.001);结节病组的两侧肺门淋巴结对称性肿大发生率高于淋巴瘤组,差异有统计学意义(P=0.006);结节病组的淋巴结融合率低于淋巴瘤组,差异有统计学意义(P=0.007)。结论结节病和淋巴瘤在肿大淋巴结的大小、两侧肺门淋巴结是否对称性增大、淋巴结的融合倾向方面有差异,PET/CT作为全身性的检查方法,对其鉴别诊断有较高的价值。

Objective To explore the value of 18F-fluorodeoxyglucose(18F-FDG)PET/CT examination in the differential diagnosis of the multisystem sarcoidosis and lymphoma.Methods 18F-FDG PET/CT images of 15 sarcoidosis patients and 20 lymphoma patients admitted to our hospital from June 2009 to May 2018 were retrospectively analyzed.All cases were confirmed by pathology.The size of the largest lymph node,mean maximum standard uptake value(SUVmax)of the lymph nodes,whether the bilateral hilar lymph nodes were symmetrically enlarged,and presence of fusion,necrosis,calcification of the enlarged lymph nodes were recorded in the two groups.Results There were no significant differences in the SUVmax,calcification of the lymph node,and necrosis of the lymph node between the two groups(all P>0.05).The size of the largest lymph node in the sarcoidosis group was significantly smaller than that in the lymphoma group,the difference was statistically significant(P=0.001).The symmetric enlargement in the bilateral hilar lymph nodes in the sarcoidosis group was higher than that in the lymphoma group,the difference was statistically significant(P=0.006).Lymph node fusion in the sarcoidosis group was lower than in the lymphoma group,the difference was statistically significant(P=0.007).Conclusion There are differences between sarcoidosis and lymphoma in the size of enlarged lymph nodes,symmetry of bilateral hilar lymph nodes and the tendency of lymph node fusion.As a general examination method,PET/CT is of great value in the differential diagnosis of sarcoidosis and lymphoma.