目的：分析18F-FDG PET/CT在骨巨细胞瘤（Giant cell tumor，GCT）中的诊断价值及其在PET/CT中的表现特点。方法：回顾分析解放军总医院骨科11例经病理证实GCT患者的PET/CT影像及临床资料，总结PET/CT在该病中的影像学特点及其优势。结果：11例GCT患者中，发生部位分别为：颈椎3例，胸椎2例，腰椎2例，四肢长骨4例，其中2例术后复发，2例转移。11例GCT患者的PET/CT影像学表现为：11例GCT患者均伴有不同程度的FDG摄取异常增高，SUVmax平均值为10.15±4.42。同机CT以溶骨性骨质破坏为主11例，其中3例可见钙化及骨硬化影存在，膨胀性溶骨性骨质破坏8例，偏心性生长7例，侵犯周围软组织6例，伴有动脉瘤样骨囊肿2例。11例GCT患者中，病理分级Ⅰ级4例，SUVmax平均值为7.73±3.15；Ⅱ/Ⅲ级7例，SUVmax平均值为12.17±4.45。结论：全身18F-FDG PET/CT显像在GCT诊断中起着重要的作用，且GCT患者PET/CT具有一定的特征性表现，有助于早期发现转移，排除恶性疾病，指导临床决策。
Abstract
Objective: To analyze the diagnostic value of 18F-FDG PET/CT in giant cell tumor(GCT). Methods: We retrospectively analyzed the clinical data and PET/CT images of 11 cases of GCT patients confirmed by pathology from orthopaedic department of the PLA general hospital. Characteristics and advantages of PET/CT in the diagnosis of GCT were summarized. Results: Among these 11 cases of GCT, the giant cell tumors occured at different sites: 3 cases in cervical vertebra, 2 cases in thoracic and lumbar vertebra and 4 cases in limbs long bone. There were 2 cases of postoperative recurrence and 2 cases of metastasis. The characteristics of PET/CT imaging of the 11 cases of GCT were as the following: 11 cases of GCT had various degrees of FDG uptake, with the average SUVmax of 10.15±4.42. All of the 11 cases of GCT showed osteolytic bone destruction in transverse CT images, including 3 cases with calcification and bone sclerosis, 8 cases with expansive growth, 7 cases with eccentric expansion, 6 cases with soft tissue mass, 2 cases with neurysmal bone cyst. According to the pathology classification, there were 4 cases of grade Ⅰ, with an average SUVmax of 7.73±3.15 and 7 cases of grade Ⅱ/Ⅲ, with an aerage SUVmax of 12.17±4.45. Conclusion: Whole body 18F-FDG PET/CT performs an important role in the diagnosis of GCT. The characteristic manifestations of GCT in 18F-FDG PET/CT can help in early detection of metastasis and exclusion of malignant diseases, so that to guide clinical management of GCT.
关键词
巨细胞瘤 /
骨 /
正电子发射断层显像术 /
体层摄影术 /
X线计算机
Key words
Giant cell tumor of bone /
Positron-emission tomography /
Tomography, X-ray computed
中图分类号：
Ｒ738.41
Ｒ817.4
Ｒ814.42
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