横纹肌肉瘤的^(18)F-FDG PET/CT表现

Imaging Features of Rhabdomyosarcoma on ~(18)F-FDG PET/CT

目的 探讨横纹肌肉瘤(RMS)的^(18)F-氟代脱氧葡萄糖(^(18)F-FDG) PET/CT表现,提高对RMS的认识及诊断准确率。方法 回顾性分析2012年10月至2022年2月郑州大学第一附属医院41例经病理证实的RMS患者的临床资料及^(18)F-FDG PET/CT表现,比较不同病理分型RMS、成人与儿童RMS的肿瘤最大标准化摄取值(SUV_(max))及肿瘤/肝脏最大标准化摄取值比值(TLR)。结果 41例患者中,胚胎型21例,腺泡型10例,梭形细胞型3例,多形型1例,类型不明6例。胚胎型RMS和其他病理类型RMS SUV_(max)分别为9.34±4.64与10.93±5.12,TLR分别为4.18±1.98与4.38±1.94,差异均无统计学意义(P>0.05)。儿童RMS和成人RMS SUV_(max)分别为9.22±4.35与10.41±5.43,TLR分别为4.46±1.67与3.96±2.37,差异均无统计学意义(P>0.05)。胚胎型及其他病理类型患者年龄分别为9(6,17)岁及20.5(13.3,33.3)岁,差异有统计学意义(Z=2.174,P=0.030)。儿童组及成人组患者胚胎型RMS分别占73.91%(17/23)及33.33%(4/12),差异有统计学意义(P=0.031)。儿童RMS和成人RMS远处转移发生率分别为29.63%(8/27)及64.26%(9/14),差异有统计学意义(P=0.033)。结论 胚胎型RMS患者年龄较其他病理类型RMS患者年龄小,儿童组胚胎型RMS较成人组多见,成人组远处转移发生率大于儿童组。不同病理类型及不同年龄RMS患者在PET/CT上的表现差异无统计学意义,但PET/CT可以较好地反映患者病灶分布范围及其代谢活性,为临床诊疗提供依据。

Objective To investigate the ^(18)F-fluorodeoxyglucose(^(18)F-FDG)PET/CT features of rhabdomyosarcoma(RMS),and to improve the understanding of RMS and the accuracy of diagnosis.Methods The ^(18)F-FDG PET/CT images and clinical date of 41 patients with RMS confirmed by pathology from October 2012 to February 2022 in the First Affiliated Hospital of Zhengzhou University were analyzed retrospectively.The maximum standardized uptake value(SUV max)and the tumour-to-liver standard uptake value ratio(TLR)in RMS of different pathological types,adults and children were calculated and compared.Results Among the 41 patients,21 were embryonal RMS,10 were alveolar RMS,3 were spindle cell RMS,1 was pleomorphic RMS and 6 were unknown type.The SUV max of embryonal RMS and other pathological RMS was 9.34±4.64 and 10.93±5.12,and the TLR was 4.18±1.98 and 4.38±1.94,showing no statistical significance(P>0.05).The SUV max of child RMS and adult RMS was 9.22±4.35 and 10.41±5.43,and the TLR was 4.46±1.67 and 3.96±2.37,showing no statistical significance(P>0.05).The age of patients with embryonal type and other pathological types was 9(6,17)and 20.5(13.3,33.3)respectively,and the difference was statistically significant(Z=2.174,P=0.030).The proportion of embryonal RMS in children group and adult group was 73.91%(17/23)and 33.33%(4/12)respectively,witha statistically significant difference(P=0.031).The incidence of distant metastasis of RMS in children and adults was 29.63%(8/27)and 64.26%(9/14)respectively,with a statistically significant difference(P=0.033).Conclusion Embryonal RMS patients are younger than other pathological RMS patients,embryonal RMS is more common in children than in adults,and the incidence of distant metastasis in adults is higher than that in children.There is no significant difference in PET/CT manifestations of RMS patients with different pathological types and different ages,but PET/CT can better reflect the distribution of lesions and their metabolic activity,providing a basis for clinical diagnosis and treatment.