南方医科大学学报 ›› 2016, Vol. 36 ›› Issue (09): 1175-.

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原发性肠淋巴瘤的18F-FDG PET/CT影像学表现

关炜,王全师,吴湖炳,周文兰   

  • 出版日期:2016-09-20 发布日期:2016-09-20

18F-FDG PET/CT findings of primary intestinal lymphoma: analysis of 23 cases

  • Online:2016-09-20 Published:2016-09-20

摘要: 目的探讨原发性肠淋巴瘤(PIL)的18F-氟代葡萄糖(FDG)PET/CT的影像学表现。方法收集2005年1月~2016年1月间 23例原发性肠淋巴瘤患者的临床及18F-FDG PET/CT资料,对病灶的分布、形态、代谢表现进行回顾性分析及总结。结果23例 PIL以弥漫性大B细胞淋巴瘤(DLBCL)与肠病相关性T细胞淋巴瘤(EATL)为主要病理学类型,分别占47.8%和43.4%。回肠、 回盲部及升结肠为PIL常见发病部位,共占57.0%。所有42个肠道病灶均呈18F-FDG浓聚,最大标准摄取值(SUVmax)为15.2±8.1 (3.6~33.7),其中DLBCL组与EATL组间SUVmax差异无统计学意义,(t=1.851,P=0.073)。肠壁呈弥漫性均匀性或不均匀性增厚 是PIL 肠道病灶的主要形态学表现,DLBCL组与EATL 组在肠道病灶形态学上的差异无统计学意义(χ2=0.426,P=0.514)。 26.2%的患者存在病灶处肠腔瘤样扩张,DLBCL组其发生率高于EATL组(χ2=8.101,P=0.004)。56.5%患者存在腹部淋巴结侵 犯,30.4%见少量腹腔积液。结论原发性肠淋巴瘤在18F-FDG PET/CT显像上具有一定特点,同时,18F-FDG PET/CT是检测原 发性肠淋巴瘤的肠内外病灶并显示该病影像学征象的灵敏影像学技术,对该病的诊断有重要价值。

Abstract: Objective To investigate the characteristic 18F-FDG PET/CT findings in patients with primary intestinal lymphoma (PIL). Methods We collected the clinical and 18F-FDG PET/CT data of 23 patients with PIL who underwent 18F-FDG PET/CT in our center between January, 2005 and January, 2016. The location, morphologies and metabolic features of the lesions were analyzed in these patients. Results In the 23 PIL patients, diffusive large B cell lymphoma (DLBCL) and enteropathyassociated T cell lymphoma (EATL) were the primary histopathological types, accounting for 47.8% and 43.4% of the total patients, respectively. The ileum, ileocecus and ascending colon were the most commonly compromised locations (57.0%). All the 42 intestinal lesions showed 18F-FDG-avid foci with a mean SUVmax of 15.2±8.1 (range 3.6-33.7), and no significant difference was found in SUVmax between DLBCL and EATL groups (t=1.851, P=0.073). Diffusive regular or irregular intestinal wall thickening was the primary CT finding in PIL lesions without significant difference between the two groups (χ2=0.426, P= 0.514). The aneurismal sign was found in 26.2% (11/42) lesions, more commonly seen in the patients with DLBCL than in those with EATL (χ2=8.101, P=0.004). PET/CT detected abdominal lymph node involvement of lymphoma was detected in 56.5% of the patients, and a small quantity of asites was seen in 30.4% of the patients. Conclusion PIL presents with characteristic imaging features in 18F-FDG PET/CT. 18F-FDG PET/CT is a sensitive imaging modality for detecting inter- and extra-intestinal lesions of PIL and displays characteristic imaging features of the disease.