FDG-PET/CT对弥漫大B细胞淋巴瘤骨髓浸润诊断价值的探讨

目的 探讨18氟-氟代脱氧葡萄糖(FDG)-正电子发射断层显像/计算机断层显像(PET/CT)在弥漫大B细胞淋巴瘤(DLBCL)骨髓浸润患者中的诊断价值.方法 收集2005年7月至2007年6月我中心81例初诊DLBCL患者资料,所有患者均行FDG-PET/CT及双侧髂骨穿刺活检,部分患者在FDG骨髓代谢活跃灶直接穿刺活检.结果 81例初诊DLBCL患者,23例发现FDG骨髓代谢活跃灶,其中17例病理活检证实骨髓浸润;而双侧髂骨穿刺活检11例证实骨髓浸润.对于早期浸润患者,FDG-PET/CT与双侧髂骨骨髓活检的符合率为100%.结论 FDG-PET/CT可以全面评价骨髓状况,较双侧髂骨穿刺活检检出更多的骨髓浸润患者;在FDG骨髓代谢活跃灶直接穿刺活检,可提高穿刺检查的准确率.

Diagnostic value of FDG-PET/CT in the detection of bone marrow involvement in patients with diffuse large B-cell lymphoma

Objective To evaluate the diagnostic value of bone marrow(BM) involvement detected by F-18-flurodeoxyglueose-positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with newly diagnosed diffuse large B-cell lymphoma(DLBCL).Methods The study population comprised 81consecutive patients with newly diagnosed DLBCL.All patients had both 18F-FDG PET/CT and standard BM biopsy at iliac crest.In 9 patients,additional direct BM biopsy at FDG-avid bone lesion was performed.Results Among all 81 eases,23 were diagnosed as BM involvement by PET/CT.Of the 23 positive eases 17 were confirmed by biopsy.However,only 11 eases were diagnosed by merely bilateral iliac crest biopsy.In patients in early stage of disease 18F-FDG PET/CT had the same results as bilateral iliae crest biopsy.Conclusion 18F-FDG PET/CT is superior to standard BM biopsy in detecting BM involvement in newly diagnosed DLBCL patients.In patients with FDG-avid bone lesions,direct PET/CT-guided bone biopsy seems to be.more accurate than standard BM biopsy.