目的：探讨正电子发射型计算机断层显像/X线计算机体层成像（PET/CT）在儿童神经母细胞瘤（NB）诊断中的临床应用价值。方法31例确诊NB患儿行氟-18-脱氧葡萄糖（18F-FDG）PET/CT，按治疗情况分为治疗前组、放化疗组、术后组。定性及定量分析其原发和转移灶的阳性率、发生部位及影像特征。结果31例患儿中，原发灶CT阳性21例（67.7%）；原发灶PET阳性14例（45.2%），其中治疗前组9例均为阳性（100%），放化疗组3例阳性（75.0%），术后组2例阳性（11.1%）。21例患儿见转移（67.7%），最常见转移部位为淋巴结（16例）、骨及骨髓转移（13例），其次为胸膜、脑及椎管硬膜下、肝、眼球后浸润，均呈PET阳性；CT见肺部病灶2例，PET阴性。治疗前组、放化疗组、术后组的原发灶SUVmax值差异有统计学意义（H=13.89，P=0.001），治疗前组最高；治疗前组的转移灶（淋巴结、骨及骨髓、胸膜、肝、硬膜外）均呈高SUVmax值。结论 NB的原发灶均表现为高FDG代谢；PET能全面地显示转移灶的分布情况，除肺转移外，其他部位转移灶均表现为高FDG代谢；PET对诊断NB以及评估NB疗效及确定术后残留或复发具有潜在价值。%Objective To study the clinical value of 18F-FDG PET/CT in childhood neuroblastoma (NB). Methods 18F-FDG PET/CT was performed in 31 children diagnosed with NB. According to the treatment conditions, patients were divided into pre-therapy group, radiation and chemotherapy group, postoperative group, respectively. The positive rate, sites, and im-age characteristics of the primary lesion and metastasis lesion were analyzed through qualitative and quantitative analysis of the image. Results Twenty-one (67.7%) and fourteen (45.2%) patients were found positive in primary sites by CT and PET respectively. All cases (9/9, 100%) in pre-therapy group were found positive in primary lesions by PET, 3 positive cases (75.0%) in radiation and chemotherapy group and 2 positive cases (11.1%) in postoperative group. Twenty-one patients showed metas-tases (67.7%). Lymph nodes (16 cases) and bone (bone marrow) (13 cases) were the most common sites of metastasis followed by pleura, meninges, liver and retrobulbar inifltration, all of which showed increased FDG uptake. Two patients were found lesions in lungs by CT, but had no FDG uptake. SUVmax of primary lesions was signiifcantly different among pre-therapy, chemotherapy and postoperative group (H=13.89, P=0.001), and pre-therapy group had the highest value. Metastases (lymph nodes, bone and bone marrow, pleura, liver and meninges) in pre-therapy group had high SUVmax. Conclusions NB primary tumors are characterized by the increased FDG metabolism. PET can fully detect the distribution of NB metastases in whole body. Except the pulmonary metastasis, metastases in other positions show increased FDG uptake. PET has potential role in evaluating the efifcacy of radiation and chemotherapy, and identifying postoperative residual or recurrence.
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