^18F-FDG PET／CT显像全身骨髓代谢弥漫增高原因分析

目的分析^18F—FDG PET／CT所示全身骨髓代谢弥漫性增高临床原因。方法收集2005年8月至2009年11月期间在该院行^18F-FDG PET／CT检查，发现全身骨髓代谢弥漫性增高且已确诊的病例66例，分析影像学表现，并进行临床病程随访和病理结果分析。选择79名健康人作为对照组；分别测量骨髓代谢增高组和对照组的骨髓SUVmax和SUVmean以及纵隔SUVmax和SUVmean，并计算最大值比（SUVmax／纵隔SUVmax）及平均值比（骨髓SUVmean／纵隔SUVmean），采用单因素方差分析对结果进行分析。结果（1）全身骨髓代谢弥漫l生增高原因有：近期升白细胞药物注射史27例，血液病21例，发热18例。（2）将上述3组及对照组SUVmean比（3．076±1．955，3．633±2．405，2．546±0．791，1．026±0．190）进行方差分析，F=34．465，P〈0．001，差异有统计学意义。健康对照组与3组骨髓代谢增高组进行多重比较，P均〈0．001，提示对照组与骨髓代谢增高组的SUVmean比差异均有统计学意义。（3）根据SUVmean比将骨髓代谢增高的程度分为2级：轻度（SUVmean比2．0—3．0）和重度（SUVmean大于3．0）。（4）3组骨髓代谢弥漫增高组中部分患者会伴有肝脾肿大及代谢增高，较常见的为血液病和发热。结论^18F-FDG PET／CT显像可以较敏感和准确地观察全身骨髓代谢的改变情况，良性和恶性病变均可引起骨髓代谢不同程度增高。

Analysis on the reasons for diffuse 18F-FDG uptake by bone marrow using whole-body PET/CT

Objective To analyze the causes for diffuse bone marrow uptake of 18F-FDG on PET/CT scans. Methods Sixty-six patients with diffuse bone marrow uptake on whole-body FDG-PET/CT imaging were enrolled for this study. Seventy-nine healthy subjects ( with no history of tumor or recent fever) were selected as normal control. The SUVmax and SUVmean were measured in bone marrow and mediastinum in both groups. The maximum (bone marrow SUVmax/ mediastinum SUVmax) and mean value ratios (bone marrow SUVmean/ mediastinum SUVmean) were calculated. Statistical analysis was performed by one-factor variance analysis. Results With diffuse bone marrow uptake pattern of 18F-FDG, 27 were caused by injection of hematopoietic growth factor, 21 by hematopathy and 18 due to fever. SUVmeanof those three causes were 3.076±1.955, 3.633±2.405 and 2.546±0.791 respectively, each was significantly different from that of the control group (1.026±0.190; F =34.465, P<0.001). Conclusion Diffuse bone marrow uptake on FDG-PET/CT are caused by both benign and malignant reasons.