18F-FDG PET/CT在原发性骨肉瘤诊断中的影像学特征

目的：探讨18F-FDG PET/CT显像在骨肉瘤诊断中的影像学特征.方法：对在2005年1月至2011年5月在本院就诊经病理检查确诊的原发性骨肉瘤患者行18F-FDG PET/CT全身显像,采用感兴趣区（ ROI）技术计算肿瘤病灶的SUVmax,同时分析同机CT扫描图像的影像学特点,着重研究肿瘤新生骨及软组织肿块特点.结果：10例原发性骨肉瘤患者的原发病灶均位于干骺端,其中位于股骨下端6例,肱骨上端2例,股骨颈和胫骨上段各1例,1例发现有“跳跃性转移灶”.同机CT影像表现为骨质破坏、肿瘤骨、骨膜反应或骨膜三角和软组织肿块.其中,肿瘤骨对18F-FDG呈低摄取,而非癌骨区或软组织肿块对18F-FDG摄取明显增高.“跳跃性转移灶”呈明显18F-FDG高摄取.结论：18F-FDG PET/CT实现了对原发性骨肉瘤解剖结构改变和代谢变化的优势互补,对骨肉瘤的诊断及治疗提供了依据.

Imaging characteristics of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in the diagnosis of osteosarcoma

Objective：To investigate the imaging characteristics of is F-fluorodeoxyglucose postitron emission tomography/computed tomography （lSF-FDG PET/CT） in the diagnosis of osteosarcoma. Methods： We enrolled ten patients with pathologically confirmed diagnosis of osteosarcoma who underwent whole body s F-FDG PET/CT imaging in The First Affiliated Hospital of Guangzhou Medical College between January 2005 and May 2011. Maximal standard uptake value （SUVmax） of tumor was calculated by adapting region of interest （ROI） technology, and the characteristics of CT imaging were analyzed simultaneously, and particularly, neoplastic bones and soft tissues of the tumor. Results： All primary lesions of ten patients were located in metaphysis, including the inferior femur （6 cases）, superior segment of humerus （2 cases）, femur neck （ 1 case） and superior segment of tibia （ 1 case） , with a single case being found to present skip metastasis loci. Simultaneously revealed in CT were bone destruction, tumorigenic bone, periosteal reaction or Codman＇ s triangle, and soft tissues. The tumorigenic bone was associated with low 18 F-FDG uptake, and by contrast, non-tumorigenic bones or soft tissues were associated with conceivably higher uptake of ~SF-FDG. Skip metastasis foci were found as having high 1SF-FDG uptake. Conclusion： lSF-FDG PET /CT should be considered as worthwhile for the diagnosis and treatment of osteosarcoma doe to integration of variation in anatomical structure and metabolism.