继发性骨淋巴瘤的18F-FDG PET/CT影像学表现

目的 探讨继发性骨淋巴瘤在18F-FDG PET/CT显像中的影像学特点。 方法 对2012年4月至2015年6月行全身18F-FDG PET/CT显像的46例继发性骨淋巴瘤患者的PET/CT影像学表现进行回顾性分析。并将骨髓穿刺结果分为阳性和阴性两组，对两组显像相应穿刺部位（髂棘）SUV进行独立样本t检验，同时绘制穿刺部位SUV诊断继发性骨淋巴瘤的受试者工作特征曲线（ROC）。 结果 46例继发性骨淋巴瘤患者中，霍奇金淋巴瘤6例、非霍奇金淋巴瘤40例；单发10例，多发18例，全身弥漫分布18例。46例患者骨质异常表现多样，其中，骨髓浸润型31例（67.40%）、混合型10例（21.74%）、硬化型3例（6.52%）、溶骨型2例（4.34%）。46例患者中肱骨或股骨受累32例（69.57%），均为骨髓浸润型表现。骨髓穿刺阳性组及阴性组SUV独立样本t检验结果显示t=4.036，P < 0.001，提示两组差异有统计学意义。穿刺部位SUV诊断继发性骨淋巴瘤的ROC曲线结果显示SUV诊断界值为2.35，其诊断继发性骨淋巴瘤的特异度和灵敏度分别为83.3%和80.0%。 结论 继发性骨淋巴瘤的18F-FDG PET/CT影像学表现存在一定的特征性，在该病的诊断与鉴别诊断中具有重要的临床价值，且对骨髓穿刺部位的选择具有指导意义。

Analysis on 18F-FDG PET/CT imaging characteristics in secondary bone lymphoma

Objective To investigate the 18F-FDG PET/CT imaging characteristics in secondary bone lymphoma.Methods A total of 46 patients with 18F-FDG PET/CT imaging of secondary bone lymphoma from April 2012 to June 2015 were selected;the PET/CT imaging characteristics were retrospectively analyzed.The patients were divided according to the results of their bone marrow biopsies:negative and positive groups.The SUV of the biopsy sites in 18F-FDG PET/CT imaging between the two groups were compared by independent sample t test,and the receiver operating characteristic curve (ROC) of the SUV in the puncture sites in the diagnosis of secondary bone lymphoma was drawn.Results The 46 cases of secondary bone lymphoma included 6 cases of Hodgkin's lymphoma and 40 cases of nonHodgkin's lymphoma.The cases comprised 10 cases of single bone lesion,18 cases of multiple bone lesions,and 18 cases of diffuse bone lesions in the whole body.The bone densities of the 46 cases were abnormal with the following conditions:31 cases of bone marrow infiltration type (67.40％),10 cases of mixed type (21.74％),3 cases of sclerosis type (6.52％),and 2 cases of osteolysis type (4.34％);32 cases of humeral or femoral involvement (69.57％) with the bone marrow infiltration type was included.The independent sample t-test in the negative and positive groups showed a t value of 4.036,P＜0.001,revealing that the difference was statistically significant.The ROC curve of the SUV in the puncture sites in the diagnosis of secondary bone lymphoma showed a cut-off value of 2.35;the specificity and sensitivity of the diagnosis of secondary bone lymphoma were 83.3％ and 80.0％,respectively.Conclusions The PET/CT imaging features of secondary bone lymphoma showed certain characteristics that are important and of clinical value to the diagnosis and differential diagnosis of secondary bone lymphoma,thus revealing that it has instructional significance for choosing biopsy sites.