肾淋巴瘤18F-脱氧葡萄糖正电子发射计算机断层显像/X线计算机断层摄影多种影像模式分析

Renal lymphoma 18F-fluorodeoxyglucose positron emission computed tomography/X-ray computed tomography analysis of multiple image patterns

目的:探讨肾淋巴瘤18F-脱氧葡萄糖(18F-FDG)正电子发射计算机断层显像(PET)/X线计算机断层摄影(CT)多模式影像学表现及其临床表现。方法:选取2011年1月至2018年12月郑州大学第一附属医院核医学科行18F-FDG PET/CT显像经病理确诊或多种影像确诊的99例肾淋巴瘤患者,男69例,女30例,年龄(45±23)岁,年龄范围为3~86岁。检测实验室检查肾功能指标(肌酐、尿素、尿酸),观察18F-FDG PET/CT表现,并测量最大标准摄取值(SUV max),观察同时行增强CT或MRI的患者其强化方式及MRI信号特征。结果:10例患者肌酐升高(117~389μmol/L);17例患者尿素升高(8.40~50.35μmol/L);15例患者尿酸升高(441~1044μmol/L)。多结节型,共35例,SUV max为14.92±8.69。单结节型,共22例,SUV max为12.25±5.78。腹膜后浸润型,共12例,SUV max为16.53±8.01。肾周型,共5例,SUV max为11.16±3.54。肾窦型,共3例,SUV max为9.57±4.45。弥漫浸润型,共17例,SUV max为10.04±5.44。混合存在,共5例,SUV max为14.32±6.92。肾淋巴瘤不同分型之间的SUV max比较,差异无统计学意义(P>0.05)。有60例患者同时行增强CT,5例行MRI,增强CT均表现为无或轻中度进行性延迟强化,密度均匀,6例伴轻微坏死或囊变,6例增强CT未能检出肾病灶,MRI平扫T1WI呈低、等或者略高信号,T2WI呈等或低信号,弥散加权成像呈显著高信号,病灶均检出。结论:肾淋巴瘤18F-FDG PET/CT显像诊断灵敏度高,在其诊断、分期评价方面均具有重要的作用。

Objective To investigate 18F-fluorodeoxyglucose(18F-FDG)positron emission tomography(PET)/computed tomography(CT)multimodal imaging features and clinical manifestations of renal lymphoma.Methods A retrospective study was performed on 99 cases of patients with renal lymphoma who were admitted in the department of Nuclear Medicine,the first Affiliated Hospital of Zhengzhou University and underwent 18F-FDG PET/CT from January 2011 to December 2018.There were 69 males and 30 females,with an average age of(45±23)years old,ranging from 3 to 86 years old.Renal function indexes(creatinine,urea,uric acid)were detected in the laboratory,the expression of 18F-FDG PET/CT was observed,and the maximum standard value(SUVmax)was measured.The enhancement mode and MRI signal characteristics of patients undergoing enhanced CT or MRI were observed.Results Creatinine in 10 cases had different degrees of elevation(117~389μmol/L);urea in 17 cases had different degrees of elevation(8.40~50.35μmol/L);uric acid in 15 cases had different degrees of elevation(441~1044μmol/L).There were 35 cases of multinodular type,SUVmax was 14.92±8.69.There were 22 cases of solitary lesion type,the SUVmax was 12.25±5.78.There were 12 cases of retroperitoneal infiltration,SUVmax was 16.53±8.01.There were 5 cases of perirenal type,SUVmax was 11.16±3.54.There were 3 cases of renal sinus type,SUVmax was 9.57±4.45.There were 17 cases with diffuse infiltration,SUVmax was 10.04±5.44.The SUVmax of the mixed forms in 5 cases was 14.32±6.92.There was no significant difference in SUVmax between different types of renal lymphoma(P>0.05).Enhanced CT was performed in 60 patients and MRI in 5 patients.Enhanced CT showed no or mild to moderate progressive delayed enhancement and even density,6 cases with slight necrosis or cystic change,6 cases of enhanced CT failed to detect renal lesions.MRI plain scan showed low,equal or slightly high signal on T1WI,equal or low signal on T2WI,and significantly high signal on diffusion weighted imaging.All lesions were detected.Conclusion 18F-FDG PET/CT imaging of renal lymphoma has high diagnostic sensitivity and plays an important role in the diagnosis and staging.