| 李 勇,张 莹,林 琳.18F-FDG PET/CT在多发性骨髓瘤诊断中的应用[J].肿瘤学杂志,2017,23(6):483-488. |
| 18F-FDG PET/CT在多发性骨髓瘤诊断中的应用 |
| Application of 18F-FDG PET/CT to the Diagnosis of Multiple Myeloma |
| 投稿时间：2017-03-08 |
| DOI：10.11735/j.issn.1671-170X.2017.06.B006 |
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| 中文关键词: 骨髓瘤 18F-FDG PET/CT SUVmax |
| 英文关键词:myeloma 18F-FDG PET/CT SUVmax |
| 基金项目:黑龙江省教育厅科学技术研究项目（12541355）；黑龙江省自然科学基金（D201128） |
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| 中文摘要: |
| 摘 要：［目的］ 探讨18F-FDG PET/CT对于多发性骨髓瘤的诊断价值。［方法］ 选择拟诊断为骨髓瘤的30例患者，利用CT、PET及PET/CT 3种诊断方法分别进行诊断，并与病理结果（23例骨髓瘤，7例骨骼转移瘤）进行对照，分析不同方法的诊断灵敏度和特异性。［结果］ PET诊断的灵敏度为34.8%~47.8%，特异性为57.1%~71.4%，诊断符合率为40.0%~50.0%；CT诊断上述指标分别为73.9%~86.9%、71.4%~85.7%和80.0%~86.6%；PET/CT诊断分别为82.6%~100%、42.9%~71.4%和 80.0%~90.0%。PET/CT诊断的灵敏度和诊断符合率均高于PET和CT。本研究中观察到：（1）骨髓瘤与骨骼转移瘤均容易侵犯脊柱、骨盆，四肢及肋骨。骨髓瘤侵犯颅骨的几率高于骨骼转移瘤。（2）骨髓瘤病灶的SUVmax为3.46±1.52，骨转移瘤病灶为4.59±3.39，差异无统计学意义（t=1.270，P=0.216）。骨髓瘤病灶SUVmax与健康者不同部位骨骼（颅骨、脊柱、骨盆、四肢、肋骨）的SUVmax差异均有统计学意义（P均＜0.05）。（3）颅骨“穿凿”样骨质破坏，肋骨膨胀性骨质破坏、脊柱骨质疏松样改变、18F-FDG的不均匀分布、轻微性分布等特征可以提高骨髓瘤的诊断率。（4）CT影像特征是PET/CT诊断骨髓瘤的的关键因素。［结论］ 18F-FDG PET/CT在诊断骨髓瘤具有较高的价值，但需与其它多发骨骼转移瘤相鉴别。 |
| 英文摘要: |
| Abstract：［Objective］ To investigate the diagnostic value of 18F-FDG PET-CT in multiple myeloma(MM). ［Methods］ Thirty patients who were intend to diagnose with myeloma were selected and were diagnosed by CT，PET and PET/CT respectively. The sensitivity and specificity of these methods were acquired by comparing with the pathological results later. The pathological results showed that 23 patients were diagnosed as MM，7 patients were diagnosed as bone metastases. ［Results］ The sensitivity，specificity and diagnostic coincidence rates of PET imaging were 34.8%～47.8%，57.1%～71.4% and 40.0%～50.0%；the above indexes of CT imaging were 73.9%～86.9%，71.4%～85.7% and 80.0%～86.6%，the above indexes of PET/CT imaging were 82.6%～100%，42.9%～71.4%，and 80.0%～90.0%. The results show that the sensitivity and diagnostic coincidence rate of PET/CT imaging was higher than PET and CT imaging. This study observed that：(1) Both myeloma and bone metastases are prone to invade spine，pelvis，limbs and ribs. Myeloma may be more likely to invade the skull. (2)The SUVmax of myeloma lesion was 3.46±1.52 and the SUVmax of bone metastases was 4.59 ±3.39. There was no statistical difference between the two groups(t=1.270，P=0.216). There was statistical difference of the SUVmax between myeloma lesions and healthy bones such as skull，spine，pelvis，limbs and ribs，(P<0.05). (3)“Punched-Out” lesions in the skull，ribdistended destruction，osteoporotic changes in the spine，18F-FDG uneven distribution and low distribution can improve the diagnosis rate of myeloma. (4)CT imaging features are the key factors in the PET/CT diagnosis of myeloma. ［Conclusion］ 18F-FDG PET/CT is very valuable in the diagnosis of myeloma，but still need to be differentiated from the other multiple bone metastases. |
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