^18F-FDG PET/CT在原发性胃弥漫大B细胞淋巴瘤诊断与鉴别诊断中的价值

目的分析原发性胃弥漫大B细胞淋巴瘤（PGDLBCL）的18F-FDG PET/CT影像学特点,探讨其在PGDLBCL的诊断和鉴别诊断价值。方法回顾性分析22例经病理证实的PGDLBCL患者的18F-FDG PET/CT资料,观察病变的部位、范围、最大厚度（THKmax）、CT值、最大标准摄取值（SUVmax）及淋巴结受累情况。将正常胃和进展期胃癌（AGC）患者各30例作为对照。采用统计学分析3组病例之间的可能差异。结果 PGDLBCL的PET/CT表现以不同形式及程度的胃壁增厚和显著增高的18 F-FDG代谢为主要特征。16例（72.73%）为弥漫性增厚,5例（22.73%）为节段性增厚,1例（4.55%）为局限性增厚。THKmax值为（2.74±1.40）cm。CT平扫密度均匀,CT值为（36.82±2.83）HU;SUVmax值为（19.96±5.47）。13例（59.09%）伴有多个区域淋巴结转移。与AGC相比,弥漫性增厚、局限性增厚、SUVmax值（9.35±4.42）及多区域淋巴结转移发生率等征象差异均有统计学意义（均P〈0.05）;而节段性增厚（8,26.67%）、THKmax值（2.38±1.27cm）及CT值（35.20±5.41HU）等征象差异均无统计学意义（均P〉0.05）。结论 18 F-FDG PET/CT有助于全面反映PGDLBCL的病理学、生物学特性,在诊断及鉴别诊断中具有较高的临床价值。

The usefulness of 18 F-FDG PET/CT for the diagnosis of primary gastric diffuse large B cell lymphoma

Objective To investigate the usefulness of 18 F-FDG PET/CT for the diagnosis and differentiation of pri-mary gastric diffuse large B cell lymphoma （PGDLBCL）.Methods Retrospective analysis of imaging characteristic of 18 F-FDG PET/CT in 22 patients with primary gastric diffuse large B cell lymphoma （PGDLBCL）confirmed by Pathol-ogy.The location,extent,maximum thickness （THKmax）,CT value and maximum standardized uptake value （SUV-max）of the lesions were observed.30 cases of advanced gastric carcinoma （AGC）and 30 normal cases were regarded as controlled groups.Comparative analysis of possible differences between the three groups of cases.Results The PET/CT findings of PGDLBCL showed the characteristic of diverse thickened gastric wall with significantly high FDG up-take.15 cases （68.18%）had involvement of more than two locations,diffuse thickeness in 16 cases （72.73%）,seg-mental thickeness in 5 cases （22.73%）and local thickeness in 1 case （4.55%）.The THKmax of PGDLBCL was （2.74 ±1.40）cm.CT images showed the tumors were uniform density and CT values were （36.82±2.83）HU.The SUV-max of PGDLBCL was （19.96±5.47）.Compared with AGC,there were significant differences in the following signs, including multi-locations,diffuse thickeness,local thickeness,the SUVmax and lymphadenopathy （all P 〈 0.05）.No significant differences were found in segmental thickenedss,the THKmax and the CT values（all P 〉0.05）.Conclusion ^18 F-FDG PET/CT could more fully reflect the pathological and biological characteristics.