对比菊池病与菊池病合并自身免疫疾病18F-FDG PET/CT表现

Comparison on 18 F-FDG PET/CT manifestations of Kikuchi-Fujimoto disease and Kikuchi-Fujimoto disease complicated with autoimmune diseases

目的 对比单纯菊池病(KFD)与KFD合并自身免疫疾病病灶代谢活性的差异。方法 将18例经病理证实为KFD且接受18F-FDG PET/CT检查患者,分为单纯KFD组(n=9)及KFD合并自身免疫疾病组(n=9),观察KFD全身累及情况,比较组间临床资料、实验室检查及病灶代谢参数的差异。结果 组间患者临床资料及实验室检查差异均无统计学意义(P均>0.05)。PET/CT显示KFD患者存在全身多处淋巴结异常,如颈部、腋窝、纵隔、脾门、腹膜后、髂血管旁及腹股沟,亦可累及骨髓和脾脏。组间淋巴结受累部位、FDG摄取最高淋巴结位置及伴脾脏增大比例差异均无统计学意义(P均>0.05)。KFD合并自身免疫疾病组受累淋巴结肿瘤代谢体积(MTV)40%及病灶糖酵解总量(TLG)40%、脾脏平均标准摄取值(SUV)、骨髓最大SUV均高于单纯KFD组(P均<0.05)。结论 合并自身免疫疾病的KFD患者与单纯KFD患者之间,受累淋巴结、脾脏及骨髓代谢参数均存在差异。

Objective To compare focal metabolic activity of single Kikuchi disease(KFD)and KFD complicated with autoimmune disease.Methods Eighteen patients with pathologically confirmed KFD who underwent 18 F-FDG PET/CT were divided into single KFD group(n=9)and KFD complicated autoimmune disease group(n=9).The systemic involvements were observed,and the clinical data,laboratory tests and metabolic parameters were compared between groups.Results The clinical data and laboratory tests were not significant different between groups(all P>0.05).PET/CT showed multiple lymph node abnormalities throughout the body in KFD patients,including the neck,axilla,mediastinum,splenic hilum,retroperitoneum,parietal iliac vessels and groin,as well as bone marrow and spleen.There was no significant difference of the site of lymph node involvements,the location of the highest FDG uptake lymph nodes nor the proportion of enlarged spleen between groups(all P>0.05).The tumor metabolic volume(MTV)40%and total lesion glycolysis(TLG)40%,the mean standard uptake value(SUV)of spleen and the maximum SUV of bone marrow were all higher in KFD complicated autoimmune disease group than those in single KFD group(all P<0.05).Conclusion Metabolic parameters of the affected lymph nodes,spleen and bone marrow in KFD patients complicated with autoimmune disease were different from those in single KFD patients.