摘要
目的探讨18F-氟代脱氧葡萄糖(18F-fluorodeoxyglucose,18F-FDG)PET/CT在前列腺癌骨转移与多发性骨髓瘤(multiplemyeloma,MM)鉴别诊断中的应用价值。方法选取2014年3月至2019年1月本院收治的51例前列腺癌骨转移瘤患者和43例MM患者为研究对象,分别纳入前列腺癌组和MM组,分析两组患者18F-FDG PET/CT检查结果的差异。结果前列腺癌组患者的骨转移多累及骨盆(96.1%),其次为脊柱(88.2%);MM组全部患者的肋骨均受累(100.0%),其次为脊柱(65.1%)。前列腺癌组患者的骨盆、脊柱和股骨处病变发生率均明显高于MM组(均P < 0.05),肋骨、颅骨和肩关节处的病变发生率均明显低于MM组(均P < 0.05)。前列腺癌组患者的病灶数显著多于MM组(P < 0.05)。MM组患者病灶的骨质破坏以溶骨性病变为主(70.5%),成骨性病变较少(3.9%),而前列腺癌组患者病灶溶骨性病变、成骨性病变和混合性病变的占比接近,两组患者骨质破坏类型比较差异有统计学意义(P < 0.05)。MM组患者骨质疏松发生率显著高于前列腺癌组(P < 0.05)。PET影像学特征:前列腺癌骨转移病灶以不均匀高代谢为主,MM病灶以弥漫性轻中度代谢为主。前列腺癌组的大标准摄取值(maximum standard uptake value,SUVmax)、18F-FDG高摄取、代谢不均匀的比率均显著高于MM组(均P < 0.05)。前列腺癌组病灶的CT正常而PET异常、CT和PET均异常的发生率均显著高于MM组(均P < 0.05),CT异常而PET正常的发生率显著低于MM组(P < 0.05)。结论 18F-FDG PET/CT对前列腺癌骨转移和MM有较高的鉴别诊断价值,其能通过全面分析病灶的骨质结构和代谢活性来提高诊断效能。
Objective To investigate the effect of 18F-fluorodeoxyglucose (18F-FDG) PET/CT in differential diagnosis of bone metastasis from prostate cancer and multiple myeloma (MM). Method 51 patients with bone metastasis from prostate cancer and 43 patients with MM admitted to our hospital from March 2014 to January 2019 were divided into prostate cancer group and MM group respectively. 18F-FDG PET/CT results were retrospectively analyzed betweens the two groups. Result Bone metastases from prostate cancer were most likely to occur in the pelvis (96.1%), followed by the spine (88.2%). Ribs were involved in all patients of MM group (100.0%), followed by the spine (65.1%). The incidences of pelvic, spinal and femoral lesions in prostate cancer group were significantly higher than those in MM group (all P < 0.05), while the incidences of rib, skull and shoulder joint lesions in prostate cancer group were significantly lower than those in MM group (all P < 0.05). The average number of lesions in prostate cancer group was significantly more than that in MM group (P < 0.05). Osteolytic lesion (70.5%) was the main type of bone destruction in MM patients, and osteogenic lesion (3.9%) was rare. Osteolytic, osteogenic and mixed lesions in prostate cancer patients with bone metastasis accounted for nearly the same proportion. There was a significant difference in the types of bone destruction between the two groups (P < 0.05). The incidence of osteoporosis in MM group was significantly higher than that in prostate cancer group (P < 0.05). For PET imaging characteristics, the bone metastases of prostate cancer were mainly in homogeneous hypermetabolism, while the MM lesions were mainly in diffuse mild to moderate metabolism. The maximum standard uptake value (SUVmax), proportion of high uptake of 18F-FDG and uneven metabolism in prostate cancer group were significantly higher than those in MM group (all P < 0.05). The incidences of normal CT + abnormal PET, abnormal CT + abnormal PET in prostate cancer group were higher than that in MM group (all P < 0.05), while the incidence of abnormal CT + normal PET was lower than that in MM group (P < 0.05). Conclusion 18F-FDG PET/CT examination has a high value in differential diagnosis of bone metastasis from prostate cancer and MM. It can improve the diagnostic efficiency by comprehensively analyzing the bone structure and metabolic activity of the lesions.
作者
杨天霞
王海涛
袁岑
刘斌
YANG Tian-xia;WANG Hai-tao;YUAN Cen;LIU Bin(Department of Nuclear Medicine,West China Hospital,Sichuan University,Chengdu 610041,China)
出处
《中国医学前沿杂志（电子版）》
2019年第8期117-121,共5页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
正电子发射断层显像
前列腺癌
骨转移
多发性骨髓瘤
鉴别诊断
Positron emission tomography
Prostate cancer
Bone metastasis
Multiple myeloma
Differential diagnosis
作者简介
通讯作者:刘斌,E-mail:binl@foxmail.com.
