【摘要】 目的：探讨¹⁸ 氟-氟代脱氧葡萄糖-正电子发射计算机断层显像(fluorine-18fluorodeoxyglucose positron emission tomography，¹⁸ F- FDG PET)在淋巴瘤分期和疗效评价中的应用价值。方法：回顾分析45例淋巴瘤患者（治疗前23例，治疗后22例）¹⁸ F-FDG PET 检 测淋巴结和结外病变的结果，并与 CT、MRI 及骨髓活检结果进行比较。结果：（1） 治疗前23例52处病灶¹⁸ F-FDG-PET 检出50处，检 出率为96． 2%；其中结内29个检出27个（93． 1%），结外23个全部检出（100%）。CT 则共检出36个（69． 2%），其中结内检出26个 （89． 7%）。结外仅检出10个（43． 5%）。¹⁸ F-FDG-PET 对结内检出敏感性与 CT 类似，而结外敏感性远高于 CT（P＜0． 01） 。（2） 治疗后 22例25个病灶¹⁸ F-FDG-PET 阴性18处，特异性为72%；CT 为44． 0%，P＞0． 05，两者差别无统计学意义，考虑可能与病例数少有 关。（3） 骨/骨髓受累在45例患者中，40例¹⁸ F-FDG PET 与骨髓活检结果一致，3例¹⁸ F-FDG PET 阳性而骨髓活检阴性，行 MRI 检 查，2例阳性，另外2例骨髓活检阳性而¹⁸ F-FDG PET 阴性。结论：¹⁸ F-FDG PET 在淋巴瘤的分期和疗效评价中具有较高的敏感和特 异性，有助于准确分期和残余病变性质的鉴别。¹⁸ F-FDG PET 有一定比率的假阳性和假阴性，因此需与其它检查联合进行以提高病变 检出阳性率和准确性。更多还原

【Abstract】 Objective:To evaluate fluorine-¹⁸ fluorodeoxyglucose positron emission tomography (¹⁸ F-FDG PET)in the staging and detec ting residual masses of lymphoma.Methods:Forty-five patients with lymphoma before/after treatment were analyzed prospecnvely.¹⁸ F- FDG PET was compared with computed tomography （CT）,magnetic resonance imaging （MRI） and bone marrow biopsy （BMB） to investi- gate lymph node/extranodal manifestations and bone marrow infiltration.Results:Among 23 patients without any treatment,the sensitivities of ¹⁸ F-FDG PET and CT were 93． 1% and 89． 7%,respectively（P＞0． 05） in detecting lymph nodes,and 100% and 43． 5%,respectively （P＜0． 01） in detecting extranodal manifestations.Among 22 patients after chemotherapy,the specificities of ¹⁸ F-FDG PET and CT were 72． 0% and 44． 0%,respectively in detecting residual masses.But there was no significant difference between them,which might be corre- lated with less cases.¹⁸ F-FDG PET and BMB produced equivalent results in 88． 9%（40/45） of patients.Another 3 patients were positive by ¹⁸ F-FDG PET but negative by BMB.The two of them were confirmed by MRI.Other 2 patients were positive by BMB but negative by ¹⁸ F-FDG PET.Bone marrow infiltration of lymphoma cells was not found by CT in the presem study.Conclusions:¹⁸ F-FDG PET is a sen- sitive and specific technique in the staging and detecting residual masses of lymphoma.It is useful to differentiate active tumors from fibro- sis and necrosis after treatment.However,¹⁸ F-FDG PET had some false positive and negative findings,suggesting that it should be com- bined with other diagnostic methods to improve sensitivity and accuracy.更多还原