骨盆功能不全性骨折^(18)F-FDG PET/CT表现

^(18)F-FDG-PET/CT manifestations of pelvic insufficiency fracture

目的观察骨盆功能不全性骨折(PIF)^(18)F-FDG PET/CT表现。方法回顾性分析23例接受^(18)F-FDG PET/CT检查的PIF患者,观察其PET/CT表现。结果23例PIF中,17例为肿瘤患者,均未见明显骨转移;6例因排查肿瘤而接受检查,均排除肿瘤;其中20例(20/23,86.96%)为双侧、3例(3/23,13.04%)为单侧PIF,多累及骶、髂骨,少数累及耻骨;主要表现为骶骨翼或/和骶骨体或/和髂骨高密度影,部分病灶可见骨折线,累及耻骨时表现为局部骨质中断;病灶放射性摄取轻-中度增高,最大标准摄取值(SUV_(max))为5.01±2.21,与肝脏血池平均标准摄取值比值(SUR-BP)为1.97±0.78。结论^(18)F-FDG PET/CT中,PIF主要表现为骶骨翼或/和骶骨体或/和髂骨高密度影,部分病灶可见骨折线,累及耻骨时局部骨质中断,而无溶骨性破坏及周围软组织肿块形成,伴轻-中度放射性摄取增高,有助于与骨转移癌相鉴别。

Objective To observe the ^(18)F-FDG PET/CT manifestations of pelvic insufficiency fracture(PIF).Methods Data of 23 PIF patients who underwent ^(18)F-FDG PET/CT for evaluating or screening tumor were retrospectively analyzed,and PET/CT characteristics of PIF were observed.Results Among 23 PIF patients,no obvious bone metastasis was found in 17 cases with history of tumor,while tumor was excluded in the rest 6 cases who underwent PET/CT for screening tumor.PET/CT showed bilateral PIF lesions in 20 cases(20/23,86.96%)and unilateral lesions in the other 3 cases(3/23,13.04%),mostly located in sacrum and iliac bone,and occasionally involved pubic bone,and the main manifestations included high-density shadows on sacral wing or/and sacral body or/and iliac bone with fracture lines in some lesions,and local bone interruption of the involved pubic bone.The lesions were found with light to moderate radiation uptake,the maximum standard uptake value(SUV_(max))was 5.01±2.21,and standard uptake ratio-blood pool(SUR-BP)was 1.97±0.78.Conclusion ^(18)F-FDG PET/CT manifestations of PIF included high-density shadows on sacral wing or/and sacral body or/and iliac bone,with fracture lines in some lesions,and local bone interruption without osteolytic destruction nor surrounding soft tissue mass when involved pubic bone,with light to moderate radiation uptake,being helpful for differential diagnosis of bone metastases.