【摘要】 目的探讨急性白血病（AL）髓外复发的¹⁸F-FDG PET/CT影像特点。方法回顾分析30例AL髓外复发患者的PET/CT,观察髓外受累的器官或组织类型、最大标准化摄取值(SUV_max)及骨髓FDG摄取,比较急性淋巴细胞白血病（ALL）和急性髓系白血病（AML）的差异。结果 16例ALL累及45个髓外器官或组织,14例AML累及29个髓外器官或组织;前者髓外病灶的平均SUV_max为7.38±4.46,高于后者的4.87±2.66（t=3.022,P=0.003）。ALL患者累及淋巴结及软组织的病例数均为10例,平均SUV_max分别为6.38±3.55和10.12±5.48;AML患者累及淋巴结及软组织的病例数均为6例,平均SUV_max分别为4.82±1.43和6.60±4.58（P均>0.05）。5例ALL髓内复发者骨髓均为多灶性摄取,5例AML髓内复发者3例为弥漫性摄取,2例为多灶性摄取。结论 AL髓外复发的¹⁸F-FDG PET/CT影像表现有一定特点;ALL及AML的常见髓外复发部位均为淋巴结和软组织;ALL复发病灶FDG代谢活性较高;骨髓多灶性摄取对髓内复发有提示意义。更多还原

【Abstract】 Objective To explore ¹⁸F-FDG PET/CT characteristics of extramedullary relapse in patients with acute leukemia（AL）.Methods Thirty AL patients with extramedullary relapse were retrospectively evaluated.The infiltrated organs or tissues and the maximum standardized uptake value(SUV_max)were recorded and compared between patients with acute lymphoblastic leukemia（ALL）or acute myeloid leukemia（AML）.FDG uptake pattern of bone marrow was also recorded.Results Forty-five extramedullary lesions were found in 16 ALL patients,while 29 were found in 14 AML patients.The average SUV_maxwas 7.38±4.46 in ALL patients and 4.87±2.66 in AML patients（t=3.022,P=0.003）.Among ALL patients,lymph node and soft tissue involvement were detected each in 10,with SUV_max of 6.38±3.55 and 10.12±5.48,respectively.Among AML patients,lymph node and soft tissue involvement were detected in 6,with SUV_max of 4.82±1.43 and 6.60±4.58,respectively（P>0.05）.Multiple focal bone marrow uptakes of FDG were found in 5 of 5 intramedullary recurrence ALL patients and 2 of 5 intramedullary recurrence AML patients.The other 3 intramedullary recurrence AML patients showed diffuse bone marrow uptake.ConclusionThere are certain imaging characteristics of ¹⁸F-FDG PET/CT in extramedullary relapse of AL.The common relapse sites are lymph node and soft tissues in both ALL and AML.FDG uptakes of extramedullary relapse lesions in ALL are significantly higher than those of AML.Multiple focal bone marrow uptake of FDG is valuable in predicting intramedullary recurrence.更多还原