结节病^(18)F-FDG PET显像分析

Analysis of ^(18)F-FDG PET images of patients with sarcoidosis

目的 探讨结节病1 8F 脱氧葡萄糖 (FDG)PET显像特征。方法 2 4例结节病患者 ,其中有临床症状并经病理检查证实者 5例 ,无临床症状、结节病抗原 (Kveim)试验阳性者 19例。均有胸部CT检查结果。行1 8F FDGPET显像 ,经计算机重建获得冠状、横断、矢状断面图像 ,采用目视法观察病灶的部位和形态 ,计算标准摄取值 (SUV)。结果 目视法见 2 4例患者病灶均分布于双侧肺门和纵隔 ,呈结节形串珠状连接 ,其中 1例有症状患者还伴有左侧腋窝1 8F FDG摄取增高灶。 5例有症状患者 ,结节大小为 ( 2 .16± 0 .67)cm ,SUV为 2 .68± 0 .5 8;19例无症状患者 ,结节大小为 ( 1.5 5± 0 .2 1)cm ,SUV为 1.46± 0 .2 4,前者结节大小明显大于后者 (t =3 .5 4,P <0 .0 1) ,SUV明显高于后者 (t =7 3 8,P <0 .0 1)。 2 4例中CT检查仅发现 1例肺门及纵隔病变而提示为结节病。结论 病灶分布于双侧肺门和纵隔 ,呈结节形串珠状连接为结节病1 8F FDGPET显像特征。有临床症状者 ,结节病灶大小大于无临床症状者 ,1 8F

Objective To analyse 18F-fluorodeoxyglucose (FDG) PET images of patients with sarcoidosis, make an abstract of image characteristics. Methods Twenty-four cases with sarcoidosis underwent both PET and CT. Among them, 5 were with pathologic evidence and had clinical symptoms, 19 were with positive Kveim test but asymptomatic. All 24 cases kept a fast of 6 h and the blood glucose was controlled below 6.7 mmol/L before injection of FDG. 40 min after administration, PET scan was performed with Siemens ECAT 47. After getting images through reconstruction by computer, the location and contour of the lesions were reviewed; the sizes and standardized uptake value (SUV) were measured. Results For all 24 cases, strings of nodules were observed along the hili of lungs and the mediastinum, one of them had a nodule with high uptake of 18F-FDG in the left axilla in addition to the nodules along the hili of lungs and mediastinum. Sizes of nodules of 5 cases with symptoms and of 19 without symptoms were (2.16±0.67) and (1.55±0.21) cm, respectively; SUV were 2.68±0.58 and 1.46±0.24, respectively. There was significant difference in the sizes and SUV of nodules between 5 with symptoms and 19 without symptoms (P<0.01). Only one out of the 24 cases with sarcoidosis was diagnosed by CT alone. Conclusions It was 18F-FDG PET image characteristics of sarcoidosis i.e. strings of nodules distributing along the lung hili and mediastinum. Sizes of nodules were bigger and uptakes of 18F-FDG were higher for cases with symptoms than those for the asymptomatic cases.