淋巴瘤脾脏浸润的18F-FDG PET/CT表现

摘要

目的 探讨18F-FDG PET/CT在诊断淋巴瘤脾脏浸润中的应用价值.方法 回顾经18F-FDG PET/CT诊断为淋巴瘤脾脏浸润的42例患者,分析脾脏体积、病灶大小、病灶密度、病灶最大标准摄取值(SUVmax)和正常肝脏SUVmax.结果 42例淋巴瘤脾脏浸润的18 F-FDG PET/CT表现分为3型,其中Ⅰ型(单纯弥漫型浸润)24例、Ⅱ型(单纯结节型浸润)13例,Ⅲ型(混合型浸润)5例.在淋巴瘤浸润脾脏病灶的SUV=max中,Ⅱ型、Ⅲ型＞T型(P均＜0.05),Ⅱ型与Ⅲ型差异无统计学意义.霍奇金病(HD)与非霍奇金淋巴瘤(NHL)、B细胞淋巴瘤与T细胞/NK细胞淋巴瘤、B细胞淋巴瘤与HD的脾脏浸润PET/CT分型差异均无统计学意义(P=0.07、0.18、0.17)；T细胞/NK细胞淋巴瘤与HD的脾脏浸润PET/CT分型差异有统计学意义(P=0.02).结论 18F-FDG PET/CT诊断脾脏淋巴瘤浸润有明显优势,其表现以Ⅰ型和Ⅱ型为主；淋巴瘤浸润脾脏结节样病灶的18F-FDG摄取显著高于弥漫性病灶；T细胞/NK细胞淋巴瘤累及脾脏较HD更多表现为Ⅰ型.%To observe the value of 18 F-FDG PET/CT in patients with spleen infiltration of lymphoma. Methods Forty-two patients diagnosed as spleen infiltration of lymphoma with 18 F-FDG PET/CT were retrospectively analyzed. The spleen volume, size, density, maximal standardized uptake value (SUVmax ) of the lesions in the spleen and the liver were analyzed. Results Three types of spleen infiltration were displayed with "F-FDG PET/CT, including 24 patients of type I (pure diffuse infiltration), 13 of type Ⅱ (pure nodular infiltration) and 5 of type m (mixed infiltration). SUVmax, of splenic lesions in type 0 and type DI were higher than that of type I (both P<0. 05). but there was no statistical difference between type Ⅱ and type Ⅲ. There was no statistical difference about PET/CT performances of spleen infiltration respectively between Hodgkin diseases (HD) and non-Hodgkin lymphoma (NHL), B-cell lymphoma and T-cell/ NK-cell lymphoma, nor between B-cell lymphoma and HD (P=0. 07, 0.18, 0.17), while significant difference was found between T-cell/NK-cell lymphoma and HD (P = 0. 02). Conclusion 18 F-FDG PET/CT has advantages in diagnosing spleen infiltration of lymphoma, which mainly display as type I and type Ⅱ. 18F-FDG uptake of nodular-like lesions was significantly higher than that of diffuse lesions in spleens when involved by lymphoma. Compared with HD, T-cell/NK-cell lymphoma involving spleen mostly showed as type Ⅰ