传染性单核细胞增多症的^(18)F-FDG PET/CT影像学分析

Analysis of ^(18)F-FDG PET/CT imaging in infectious mononucleosis

目的总结传染性单核细胞增多症(IM)成人患者^(18)F-脱氧葡萄糖(FDG)PET/CT影像表现。方法回顾性分析2015年7月至2019年7月同济大学附属东方医院核医学科检出的5例IM患者(均为男性,年龄18~77岁)的^(18)F-FDG PET/CT影像资料及临床资料,对病变部位(淋巴结、扁桃体、骨髓、肝等)淋巴组织的分布进行分析,并采用半定量法对病变部位^(18)F-FDG放射性摄取进行测定。结果5例IM患者全身浅表淋巴结(主要分布于颈部、腋下、腹股沟区淋巴结区)及深部淋巴结(主要分布于纵隔、肺门、腹腔、腹腔后区)均有不同程度增大及FDG摄取增高,其中浅表淋巴结最大标准摄取值(SUVmax)为1.2~7.3,深部淋巴结SUVmax为3.5~9.7;5例全身骨髓均弥漫性FDG摄取增高,SUVmax为3.0~7.9;均出现咽扁桃体不同程度肿大及FDG摄取增高,SUVmax为1.7~13.4。IM患者较淋巴瘤患者存在器官累及多和放射性摄取相对较低等差异。结论^(18)F-FDG PET/CT影像学特征有助于诊断IM。

Objective To summarize the characteristics of ^(18)F-fluorodeoxyglucose(FDG)PET/CT imaging in adult patients with infectious mononucleosis(IM).Methods ^(18)F-FDG PET/CT imaging data and clinical data of 5 IM patients(all males,age 18-77 years)detected in the Department of Nuclear Medicine of the East Hospital Affiliated to Tongji University from July 2015 to July 2019 were analyzed retrospectively.Distribution of lymphatic tissues in the lesions(lymph nodes,tonsils,bone marrow,liver,etc)and ^(18)F-FDG radioactive uptake in the lesions were analyzed semiquantitatively.Results In 5 patients with IM,the volume of superficial lymph nodes(mainly distributed in the neck,axilla,and groin lymph nodes)and deep lymph nodes(mainly distributed in the mediastinum,hilum of lung,abdominal cavity and posterior abdominal cavity)increased to varying degrees,as well as the FDG uptake.Maximum standardized uptake value(SUVmax)of superficial lymph nodes were 1.2-7.3,and those of deep lymph nodes were 3.5-9.7.All patients showed diffuse uptake of FDG in bone marrow,with SUVmax of 3.0-7.9.All patients had pharyngeal tonsillar enlargement and FDG uptake increasing,with SUVmax of 1.7-13.4.Compared with patients with lymphoma,IM patients had more organ involvement and relatively lower radioactive uptake.Conclusion ^(18)F-FDG PET/CT imaging features of IM can help the diagnosis of IM.