恶性淋巴瘤正电子发射型断层扫描技术检查的临床意义

目的：分析恶性淋巴瘤患者的正电子发射型断层扫描技术（PET）检查结果和临床情况，探讨这一新的影象学检查在恶性淋巴瘤诊治中的特点及鉴定意义。方法：对20例恶性淋巴瘤患者行PET检查，并对其中16例行CT或MRI检查。结果：（1）20例PET检查的恶性淋巴瘤患者诊断符合率高于行CT、MRI检查的患者；（2）对估计临床分期有参考作用方面PET为100％，CT、MRI占66．7％；（3）初步显示PET检查荧光脱氧核糖（FDG）摄取值高低可对区分淋巴瘤的恶性程度及预后提供依据；（4）20例患者根据PET检查代谢值变化及时调整治疗，治疗有效率为85．7％。对照组缺乏此信息，治疗调整者及治疗有效率低于前者。结论：PET检查将形态改变和代谢变化有机结合的特点，在恶性淋巴瘤全身、早期发现病变、定量分析、显示代谢功能、监测疗效、评估预后诸方面都有其优越性。该检查安全可行，但应注意鉴别假阳性反应；有糖尿病的患者需注意示踪剂对血糖的暂时影响。

Clinical significance of positron emission tomography for lymphoma patients.

OBJECTIVE: To explore the characteristics and clinical significance of positron emission tomography (PET) examination for malignant lymphoma. METHODS: PET examination was performed in 20 patients with malignant lymphoma, among whom 16 also received examination by computed tomography (CT) or magnetic resonance imaging (MRI). RESULTS: PET was found to have better diagnostic efficiency than CT or MRI examination and the former provided referential information in all the cases for estimation of the clinical stage, while CT and MRI were helpful in only 66.7% of the cases. FDG uptake as demonstrated by PET helped the assessment of the malignancies and prognosis, according to which treatment adjustment was implemented in 20 cases, resulting in a efficacy rate of 85.7%. CONCLUSION: By integrating morphological and metabolic observations, PET is a superior diagnostic modality in terms of systemic identification, early detection, quantitative analysis, evaluating metabolic function of lesion monitoring therapeutic effect and making prognostic assessment of malignant lymphoma. In spite of the safety of PET examination, false positive results were not eliminated and blood sugar in patients with diabetes might be transiently affected by the tracing agents.