22例结节病18F—FDGPET／CT影像学特征分析

目的总结结节病患者胸部及胸外病变18F—FDGPET／CT影像特征，评价其在结节病诊断中的意义。方法回顾分析2007年8月至2009年11月间，符合国内结节病诊断标准、并经病理检查和随访证实的结节病患者22例资料，其中男10例，女12例。分析18F—FDGPET／CT图像所示胸部及胸外病变。根据两侧肺门淋巴结是否为对称性增大（CT图像）和对称性放射性浓聚（PET图像）分为典型和不典型结节病两种类型。数据统计采用非参数McNemar检验、独立分组t检验和Fisher精确检验。结果PET和cT图像所示典型、不典型结节病分别为18例、4例和12例、10例，两者间组成比例差异有统计学意义（P=0．031）。CT所示不典型结节病，PET图像均显示两侧肺门淋巴结有累及，表现为对称性或不对称性放射性浓聚。胸外淋巴结以盆、腹腔淋巴结累及较常见，发生率为54．5％（12／22）；结外脏器累及最常见于肺，为86．4％（19／22）。结论结节病的胸部和胸外病变在18F—FDGPET／CT图像上有一定的特征性，有助于cT表现不典型的结节病的诊断。

18F-FDG PET/CT imaging characteristics of sarcoidosis in 22 cases

Objective To investigate the imaging characteristics of both intra- and extrathoracic sarcoidosis on 18F-FDG PET/CT.Methods From 2007 Aug.to 2009 Nov.,22 patients( 10 males,12 females) with sarcoidosis,confirmed by pathological study and clinical follow-up,underwent 18 F-FDG PET/CT imaging.The imaging patterns of intrathoracic and extrathoracic lesions were analyzed.The patterns were classified as the typical or atypical ( symmetrical or asymmetrical FDG accumulation and enlargement of hilar lymph nodes) based on PET and CT separately.Nonparametric McNemar test,independent t-test and Fisher exact test were applied for statistical analysis.Results For typical pattern vs atypical pattem identification,PET was significantly different from CT ( 18 and 4 vs 12 and 10,P =0.031 ).In those with atypical pattern demonstrated by CT alone at hilar region,PET showed either symmetrical or asymmetrical accumulation of FDG.Except for mediastinal lymph nodes involvement,lung parenchyma was the second common site ( 19/22,86.4％ ),followed by lymph nodes at abdomen and (or) pelvis ( 12/22,54.5％ ).Conclusion The imaging characteristics of both intra- and extrathoracic sarcoidosis on 18F-FDG PET/CT may be helpful for the diagnosis of atypical sarcoidosis on CT image alone.