18F-FDG PET/CT显像在多发性骨髓瘤继发骨髓外浸润中的应用价值

目的:探讨多发性骨髓瘤继发髓外浸润的¹⁸F-FDG PET/CT图像特点,提高对该表现的认识。方法:回顾性分析2012年1月至2020年10月中国科学技术大学附属第一医院21例为穿刺病理或随访证实的多发性骨髓瘤继发髓外浸润患者,所有患者治疗前均行¹⁸F-FDG PET/CT显像,分析髓外浸润PET/CT显像特点。结果:21例患者中,男12例,女9例,年龄41-77岁,平均(58.3±10.0)岁;骨髓外浸润累及淋巴结9例,肺、胃、脾脏及肾脏各2例,腹膜后、右心耳、皮下结节及脊膜受累及各1例;髓外浸润SUVmax最大值21.2,最小值2.1,平均值7.7±5.3,骨髓病变最大值33.5,最小值2.4,平均值6.6±3.6,髓外浸润与骨髓病变SUVmax比较,二者之间差异无统计学意义(Z=-1.195,P=0.232)。结论:¹⁸F-FDG PET/CT不仅对多发性骨髓瘤有很好的诊断价值,而且对继发髓外浸润也有很好的评估价值,为临床治疗及预后判断提供了一定的参考。

Value of 18F-FDG PET/CT Imaging in Secondary Extramedullary Infiltration of Multiple Myeloma

Objective:To investigate the characteristics of¹⁸F-FDG PET/CT images of multiple myeloma secondary extramedullary infiltration in order to improve recognition.Methods:Twenty-one patients with multiple myeloma secondary extramedullary infiltration confirmed by pathology or follow-up from January 2012 to October 2020 in the First Affiliated Hospital of University of Science and Technology of China were retrospectively analyzed.All the patients underwent¹⁸F-FDG PET/CT imaging before treatment,and the PET/CT characteristics of extramedullary infiltration and bone marrow were analyzed.Results:Twenty-one patients included 12 males and 9 females,aged from 41 to 77 years old,with an average of 58.3±10.0;9 cases of extramedullary infiltration involving lymph nodes;lung,stomach,spleen,and kidney were involved respectively in 2 cases;retroperitoneal,right auricle,subcutaneous nodule,and spinal meninges involvement were reported in each one case respectively.The maximum SUVmax value of extra-medullary lesions was 21.2,the minimum value was 2.1,and mean was 7.7±5.3.The maximum SUVmax value of bone marrow was 33.5,the minimum was 2.4,and mean was 6.6±3.6.There was no statistically significant difference in SUVmax value between extra-medullary lesions and bone marrow(Z=-1.195,P=0.232).Conclusion:¹⁸F-FDG PET/CT not only has a good diagnostic value for multiple myeloma,but also a good evaluation value for secondary extramedullary infiltration,which provides reference for clinical treatment and prognosis.