CAJ | 학술논문

目的分析骨转移瘤的~(18)F-脱氧葡萄糖(FDG)PET/cT影像学表现.方法 140例~(18)F-FDG PET/CT检查病例,按病灶的4种CT形态(成骨改变、溶骨改变、混合改变及无改变)分组,探讨肿瘤骨转移灶代谢表现与形态表现之间的关系,进一步治疗情况与转移灶代谢表现的关系.采用SPSS 10.0软件,行Mann-Whitney检验及χ~2检验.结果 140例患者分未治疗组78例(55.7%),治疗(化疗及内分泌)组62例(44.3%).共检出病灶1658个,CT示成骨病灶415个(25.0%),溶骨病灶567个(34.2%),混合病灶177个(10.7%),无改变病灶499个(30.1%).对未治疗组1045个病灶平均标准摄取值(SUV_(mean))行Mann-Whitney检验,混合病灶、溶骨病灶SUV_(mean)高于成骨病灶、无改变病灶(SUV_(mean)中位值分别为5.7,5.2,4.8及4.6,Z=-4.680,-6.067,-2.237,-4.635,P均<0.05);治疗组与未治疗组行X~2检验,未治疗组以溶骨性改变(39.6%)为多,治疗组以成骨性改变(35.9%)为多,组间病灶组成明显不同(χ~2=67.8,P<0.05),治疗组代谢水平明显低于未治疗组(SUV_(mean)中位值分别为4.9及4.6,Z=-4.315,P<0.05).结论骨转移病灶形态表现不同,其代谢表现差异明显,溶骨病灶的SUV_(mean)明显大于无溶骨病灶;化疗及内分泌治疗能通过对病灶转归的改变影响病灶形态及相应代谢表现.
목적 분석골전이류적~(18)F-탈양포도당(FDG)PET/cT영상학표현.방법 140례~(18)F-FDG PET/CT검사병례,안병조적4충CT형태(성골개변、용골개변、혼합개변급무개변)분조,탐토종류골전이조대사표현여형태표현지간적관계,진일보치료정황여전이조대사표현적관계.채용SPSS 10.0연건,행Mann-Whitney검험급χ~2검험.결과 140례환자분미치료조78례(55.7%),치료(화료급내분비)조62례(44.3%).공검출병조1658개,CT시성골병조415개(25.0%),용골병조567개(34.2%),혼합병조177개(10.7%),무개변병조499개(30.1%).대미치료조1045개병조평균표준섭취치(SUV_(mean))행Mann-Whitney검험,혼합병조、용골병조SUV_(mean)고우성골병조、무개변병조(SUV_(mean)중위치분별위5.7,5.2,4.8급4.6,Z=-4.680,-6.067,-2.237,-4.635,P균<0.05);치료조여미치료조행X~2검험,미치료조이용골성개변(39.6%)위다,치료조이성골성개변(35.9%)위다,조간병조조성명현불동(χ~2=67.8,P<0.05),치료조대사수평명현저우미치료조(SUV_(mean)중위치분별위4.9급4.6,Z=-4.315,P<0.05).결론 골전이병조형태표현불동,기대사표현차이명현,용골병조적SUV_(mean)명현대우무용골병조;화료급내분비치료능통과대병조전귀적개변영향병조형태급상응대사표현.
Objective To investigate the imaging characters of bone metastases on ~(18)F-fluorodeox-yglucose (FDG) PET/CT. Methods ~(18)F-FDG PET/CT studies in 140 patients had been retrospectively reviewed. The metastatic bone lesions were categorized into four groups: osteoblastic, osteolytic, mixed-type, or no change in bone density based on CT morphological features, to evaluate their relationships with the degree of ~(18)F-FDG metabolism. The correlations of the therapeutic conditions with CT morphological fea-tures and with the degree of ~(18)F-FDG metabolism were also respectively analyzed. The Mann-Whitney test and χ~2-test were performed by SPSS 10.0. Results In 140 patients, 78(55.7% ) patients were untreated and 62 (44.3%) patients had been treated by chemotherapy or hormonal therapy before this study. A total of 1658 metastatic bone lesions were found in 140 patients, including 415 osteoblastic lesions (25.0%),567 osteolytic lesions (34.2%), 177 mixed-type lesions (10.7%) and 499 lesions with normal CT ap-pearance (30.1%). Osteolytic and mixed-type lesions showed much higher ~(18)F-FDG uptake on PET/CT than osteoblastic and normal CT lesions in 1045 lesions of 78 untreated patients in terms of mean standardized uptake value (SUV_(mean)). The median of SUV_(mean) of the mixed-type, osteolytic, osteoblastic and normal CT groups was 5.7, 5.2, 4.8 and 4.6, respectively (Z=-4.680, -6.067, -2.237, -4.635, all P < 0.05). Comparing the treated and untreated groups, there were more osteolytic lesions in untreated group (39.6%) ; while more osteoblastic lesions in treated group (35.9%). The CT morphological features of the two groups showed significant difference (χ~2 = 67.8, P < 0.05). The median of SUV_(mean) of the untreat-ed group (4.9) was higher than that (4.6) of the treated group (z=-4.315, P<0.05). Conclusions There is significant metabolic difference among bone metastases with different CT morphological features.The lesions with osteolytic changes, whether purely osteolytic or mixed-type, have higher SUV_(mean) than os-teoblastic or normal CT lesions. Chemotherapy and hormonal therapy could change the metabolic features on PET and the morphologic features on CT.