8例组织细胞坏死性淋巴结炎^(18)F-FDG PET/CT表现及临床分析

Clinical and ^(18)F-FDG PET/CT features of histiocytic necrotizing lymphadenitis in 8 cases

目的分析组织细胞坏死性淋巴结炎(HNL)病人的^(18)F-脱氧葡萄糖(FDG)PET/CT表现及临床资料,提高对该病认识水平。方法回顾性分析8例经病理证实的HNL病人的^(18)F-FDG PET/CT资料,其中男4例、女4例,中位年龄26.5岁。分析HNL在^(18)F-FDG PET/CT成像上所示的受累淋巴结分布、形态、密度及摄取,并采用Pearson相关分析来确定淋巴结的^(18)F-FDG最大标准化摄取值(SUVmax)与其长径、短径之间的相关性。结果8例HNL病人^(18)F-FDG PET/CT成像均有多部位淋巴结受累,位于颈部8例(6例双侧、2例单侧),腋窝7例(5例双侧、2例单侧),肺门及纵隔4例,腹部4例,盆腔3例及腹股沟区2例(均为双侧)。受累淋巴结大都呈椭圆形,无融合,密度较均匀,无钙化及液化坏死。受累淋巴结SUVmax为12.86±5.70,长径为(1.41±0.42)cm,短径为(0.84±0.26)cm,CT值为(44.77±9.59)HU。其中短径<1 cm的淋巴结约占63.4%,SUVmax为11.21±5.80。受累淋巴结SUVmax与长径呈低度正相关(r=0.349,P=0.025),与短径呈中度正相关(r=0.504,P=0.001)。结论^(18)F-FDG PET/CT成像在HNL诊断、鉴别诊断及淋巴结活检定位中发挥重要作用。

Objective By analyzing the clinical and ^(18)F-fluorodeoxyglucose(FDG)PET/CT features of histiocytic necrotizing lymphadenitis(HNL)to raise awareness of this disease.Methods ^(18)F-FDG PET/CT data of 8 patients(4 males and 4 females,median age of 26.5 years)with histologically proved HNL were retrospectively analyzed.The distribution,morphology,density and ^(18)F-FDG uptake of lymph nodes involved in ^(18)F-FDG PET/CT imaging were analyzed,and the relationships between the maximum standard uptake values(SUVmax)and the long/short diameters were analyzed by Pearson correlation analysis.Results(6 bilateral,2 unilateral),in axilla 7 cases(5 bilateral,2 unilateral),in hilum and mediastinum 4 cases,in abdomen 4 cases,in pelvic cavity 3 cases,and in inguinal region 2 cases(both bilateral).The lymph nodes were basically oval without fusion,and the density of them was homogeneous without calcification and liquefaction necrosis.The SUVmax,long diameter,short diameter,and CT value of affected lymph nodes were 12.86±5.70,1.41±0.42 cm,0.84±0.26 cm,and 44.77±9.59 HU,respectively.The short diameter of lymph nodes less than 1 cm accounted for 63.4%,and the SUVmaxwas 11.21±5.80.The SUVmaxof lymph nodes showed a mild positive correlation with the long diameter(r=0.349,P=0.025),and a medium positive correlation with the short diameter(r=0.504,P=0.001).Conclusion ^(18)F-FDG PET/CT imaging plays an important role in the diagnosis and differential diagnosis of HNL and localizing lymph node for biopsy.