PET/CT在儿童白血病中的诊断价值

Diagnostic Value of PET/CT in Childhood Leukemia

目的:分析PET/CT在儿童白血病中的诊断价值。方法:回顾性分析2016年8月~2021年8月本院接受骨髓抑制且疑为髓内复发的60例ALL儿童18F-FDG PET/CT影像图像和临床资料,以骨髓活检为诊断金标准,将患者分为髓内复发组34例,未复发组26例,比较两组的临床参数和SUV_(max),分析PET/CT诊断ALL复发效能。结果:两组患儿间的年龄、性别、白细胞计数、C反应蛋白、LDH及发热、脾大发生率差异无统计学意义(P>0.05),两组患儿间的附肢骨SUV_(max)/中轴骨SUV_(max)、骨髓SUV_(max)/肝脏SUV_(max)及中轴骨SUV_(max)比较差异具有统计学意义(P<0.05)。附肢骨SUV_(max)/中轴骨SUV_(max)诊断ALL髓内复发的效能最好,AUC为0.822,灵敏度、特异度、准确度分别为85.30%(29/34)、73.10%(19/26)、80.00%(48/60)。结论:PET/CT诊断儿童ALL髓内复发简单、可靠,可合理地评估是否需要进一步化疗或外部放疗,而不会使儿童遭受不必要的治疗相关并发症,值得临床深入研究其效能。

Objective:To analyze the diagnostic value of PET/CT in childhood leukemia.Methods:The 18F-FDG PET/CT images and clinical data of 60 all children who underwent myelosuppression and suspected intramedullary recurrence in our hospital from August 2016 to August 2021 were analyzed retrospectively.Taking bone marrow biopsy as the diagnostic gold standard,the patients were divided into intramedullary recurrence group(34 cases)and non recurrence group(26 cases).The clinical parameters and SUV_(max)of the two groups were compared to analyze the efficacy of PET/CT in the diagnosis of all recurrence.Results:There was no significant difference in age,sex,leukocyte count,C-reactive protein,LDH,fever and splenomegaly between the two groups(P>0.05).There was significant difference in accessory limb bone SUV_(max)/axial bone SUV_(max),bone marrow SUV_(max)/liver SUV_(max)and axial bone SUV_(max)between the two groups(P<0.05).The efficiency of accessory bone SUV_(max)/axial bone SUV_(max)in the diagnosis of intramedullary recurrence of all was the best,AUC was 0.822,and the sensitivity,specificity and accuracy were 85.30%(29/34),73.10%(19/26)and 80.00%(48/60)respectively.Conclusion:PET/CT diagnosis of intramedullary recurrence of all in children is simple and reliable.It can reasonably evaluate whether further chemotherapy or external radiotherapy is needed without unnecessary treatment-related complications.It is worthy of further clinical study.