淋巴瘤单发骨病变的18F－FDGPET／CT影像学分析

目的：研究原发性骨淋巴瘤与单发继发性淋巴瘤骨髓浸润的18 F －FDG PET／CT 影像学表现，探讨18 F－FDG PET／CT 对原发性骨淋巴瘤的诊断及鉴别诊断价值。方法：回顾性分析经病理证实的25例单发骨淋巴瘤的18 F －FDG PET／CT 影像学资料。结果：25例骨淋巴瘤均为单发，其中14例位于脊柱骨，10例位于附肢骨，1例位于肋骨。15例为原发性骨淋巴瘤，10例为继发性淋巴瘤骨髓浸润。原发性骨淋巴瘤15例中非霍奇金淋巴瘤11例，霍奇金淋巴瘤4例；继发性淋巴瘤骨髓浸润10例中非霍奇金淋巴瘤7例，霍奇金淋巴瘤3例。25例骨淋巴瘤中23例 CT 表现为骨质密度异常改变，2例病变骨质密度未见明显异常改变。病变 FDG摄取不同程度增高，SUVmax范围为2．6～24．5。原发性骨淋巴瘤及继发性淋巴瘤骨髓浸润病变 SUVmax经 Mann－Whitney U 检验提示原发性骨淋巴瘤与继发性淋巴瘤骨髓浸润病变 SUVmax有差异（P ＝0．007）。结论：原发性骨淋巴瘤18 F －FDG PET／CT 影像学表现有一定的特征性，分析其表现对原发性和继发性骨淋巴瘤的诊断及鉴别诊断有一定的临床价值。

18 F -FDG PET/CT imaging analysis of lymphoma with solitary bone marrow invasion lesion

Objective:To study the 18 F -fluorodeoxyglucose(18 F -FDG)PET/CT imaging of primary lymphoma of bone and single bone marrow invasion of secondary lymphoma,and to investigate the value of 18 F -FDG PET/CT in the diagnosis and differential diagnosis of primary lymphoma of bone.Methods:PET/CT findings of 25 patients with pathology proven solitary bone lymphoma were retrospectively analyzed.Results:All 25 cases of bone lymphoma were solitary bone invasion lesion.14 cases were located in the vertebral column,10 cases in the attached bone,and 1 case in the costal bone.15 cases were primary lymphoma of bone,and 10 cases were secondary affection.15 cases of prima-ry lymphoma of bone include 11 cases of non -Hodgkin's lymphoma and 4 cases of Hodgkin's lymphoma.10 cases of secondary lymphoma include 7 cases of non -Hodgkin's lymphoma,3 cases of Hodgkin's lymphoma.CT imagines of 23 cases of bone lymphoma showed abnormal bone density,and 2 cases had no obvious abnormal changes in bone densi-ty.25 lesions all showed increased FDG uptake,and the range of maximal standard uptake value(SUVmax )was 2.6 ~24.5.Mann -Whitney U test demonstrated that there was statistical difference in SUVmax of primary lymphoma of bone and secondary lymphoma bone marrow invasion(P =0.007).Conclusion:18 F -FDG PET/CT imaging features of pri-mary lymphoma of bone are characteristic,analysis of its performance in the diagnosis and differential diagnosis of pri-mary and secondary bone lymphoma has a certain clinical value.