继发性骨淋巴瘤的18F-FDG PET/CT影像诊断及与骨髓活检诊断效能的比较

目的:分析继发性骨淋巴瘤的PET/CT影像特点,比较骨髓活检(bone marrow biopsy,BMB)及PET/CT诊断骨淋巴瘤各自的优势,探讨如何进一步提高骨淋巴瘤的检出率.方法:回顾性分析放化疗前在我院行PET/CT检查的68例继发性骨淋巴瘤影像及骨髓活检资料.所有病例均病理确诊为淋巴瘤.骨淋巴瘤病灶的诊断标...

The role of 18F-FDG PET/CT and bone marrow biopsy in identifying secondary bone lymphoma

Objective:To investigate the PET/CT imaging features of secondary bone lymphoma and analyze the advantages of bone marrow biopsy (BMB) and PET/CT imaging in the diagnosis of bone lymphoma to explore how to improve the detection rate of secondary bone lymphoma.Methods:A retrospective study of 68 patients with the diagnosis of secondary bone lymphoma who underwent PET/CT scan before radiotherapy and chemotherapy were enrolled.PET/CT findings and BMB results were analyzed.All patients were pathologically confirmed lymphoma with positive BMB results or bone lesions with high FDG uptake.Statistical analysis was performed using SPSS 16.0.Results:Comparison of PET/CT and BMB was analysed in the diagnosis of bone lymphoma.BMB was performed in 63 of 68 patients.The sensitivity of PET/CT for all 63 cases and for non-indolent lymphoma was higher than that of BMB (P＜0.05),while for indolent lymphoma,the sensitivity of BMB was slightly higher than that of PET/CT (P＞0.05).PET/CT findings and BMB results showed there were 18 cases of bone destruction and 50 cases of bone marrow infiltration.The SUVmax of the bone destruction group,mainly composed of diffuse large B cell lymphoma (DLBCL),was significantly higher than that of the bone marrow infiltration group (P＜0.01).PET/CT was positive for all bone destruction.In the bone marrow infiltration group,41 cases were positive for PET/CT,dividing into focal uptake group,focal with diffuse uptake group and pure diffuse uptake group.The SUVmax of the pure diffuse uptake group was significantly lower than that of the other two groups.BMB was negative in 21 cases,including 8 cases of bone destruction and 13 cases of focal bone marrow infiltration.Comparison of PET/CT findings was analysed among different pathological types of lymphoma.All invasive non-Hodgkin's lymphoma (NHL)(31 cases of DLBCL and 10 cases of others) and Hodgkin's lymphoma （HL）(6 cases) were positive for PET/CT,while 11 out of 18 cases of indolent lymphoma were positive.The SUVmax of DLBCL was significantly higher than that of indolent lymphoma(P＜0.05).Conclusion:Secondary bone lymphoma has more bone marrow infiltration than bone destruction lesions.Bone destruction and focal bone marrow infiltration is more common in invasive bone lymphoma,and diffuse bone marrow infiltration is often seen in indolent lymphoma.PET/CT is significantly better than BMB for bone destruction and focal bone marrow infiltration while BMB is better than PET/CT for diffuse bone marrow infiltration.BMB combined with PET/CT can improve the detection of bone lymphoma.