原发纵隔大B细胞淋巴瘤的^18F-FDGPET/CT显像表现

目的探讨原发纵隔大B细胞淋巴瘤(PMBL)的^18F-脱氧葡萄糖(FDG)PET/CT显像特征。方法回顾性分析2010年7月至2019年4月间南京医科大学第一附属医院经病理证实的27例PMBL患者男10例,女17例,中位年龄31(19~57)岁]的^18F-FDG PET/CT显像资料,观察病灶的位置、形态、密度、坏死及钙化情况、周围及远处侵犯情况等。通过阈值自动分割法计算病灶的最大标准摄取值(SUVmax)、代谢体积(MTV)和糖酵解总量(TLG)。采用Spearman相关分析评价SUVmax、MTV、TLG与最大长径、Ann Arbor分期的相关性。结果27例患者病灶表现为前纵隔肿块,其中25例肿块在前纵隔内跨区生长;24例患者病灶边缘不光整,呈分叶状;^18例患者病灶内可见低密度坏死灶;15例患者病灶包绕大血管生长;12例气管受压变窄;3例肿瘤侵犯肺组织;1例肿瘤累及腹腔淋巴结和骨髓;所有患者脾脏均未见肿大。27例患者病灶最大长径、SUVmax、MTV、TLG分别为(11.6±3.7)cm、21.07(15.78,25.09)、190.43(130.14,350.75)cm3、2165.54(1465.86,4^185.21)g。SUVmax与病灶最大长径无相关性(rs=-0.305,P=0.122),MTV、TLG均与最大长径呈正相关(rs=0.741、0.532,均P<0.05)。最大长径、MTV、TLG均与分期呈正相关(rs=0.394、0.413、0.422,均P<0.05),而SUVmax与Ann Arbor分期无相关性(rs=0.031,P>0.05)。结论PMBL^18F-FDG PET/CT显像多表现为前纵隔大肿块,^18F-FDG摄取较高,病灶内坏死多见,腹腔淋巴结、脾脏及骨髓侵犯少见;病灶MTV、TLG与Ann Arbor分期呈正相关。

Characteristics of primary mediastinal large B-cell lymphoma in ^18F-FDG PET/CT imaging

Objective To investigate the characteristics of primary mediastinal large B-cell lymphoma(PMBL)in^^18F-fluorodeoxyglucose(FDG)PET/CT imaging.Methods From July 2010 to April 2019,^^18F-FDG PET/CT images of 27 patients(10 males,17 females,median age 31(19-57)years)with pathologically confirmed PMBL from the First Affiliated Hospital of Nanjing Medical University were retrospectively analyzed.The location,shape,density,presence of necrosis and calcification,and invasion around or beyond the lesions were observed.The maximum standardized uptake value(SUVmax),metabolic tumor volume(MTV)and total lesion glycolysis(TLG)were measured by automatic segmentation algorithm method.Spearman correlation analysis was used to evaluate the correlation between SUVmax or MTV or TLG and the maximum diameter or Ann Arbor staging.Results The lesions appeared as anterior mediastinal huge masses in 27 patients,and grew in the anterior mediastinal cross-regionally in 25 patients,lobulated at the edge in 24 patients.Low-density necrosis lesions were found in^^18 patients.The lesions were surrounded by large blood vessels in 15 patients and tracheae were compressed in 12 patients.Lung tissues were invaded in 3 patients,abdominal lymph nodes and bone marrow were invaded in 1 patient,and no splenomegaly was found in 27 patients.The maximum diameter,SUVmax,MTV and TLG were(11.6±3.7)cm,21.07(15.78,25.09),190.43(130.14,350.75)cm3 and 2165.54(1465.86,4^^185.21)g,respectively.There was no correlation between SUVmax and the maximum diameter of lesions(rs=-0.305,P=0.122),while MTV and TLG were positively correlated with the maximum diameter(rs values:0.741,0.532,both P<0.05).The maximum diameter,MTV and TLG were positively correlated with Ann Arbor staging(rs values:0.394,0.413,0.422,all P<0.05),while SUVmax was not(rs=0.031,P>0.05).Conclusions PMBL mostly presents as large anterior mediastinal mass with the high^^18F-FDG uptake in^^18F-FDG PET/CT imaging,and the focal necrosis is common,while abdominal lymph nodes,spleen and bone marrow invasion are rare.MTV and TLG of lesions positively correlate with Ann Arbor staging.