CAJ | 학술논문

目的回顾性分析未知原发灶的多发性骨破坏患者PET/CT显像中骨髓瘤与骨转移瘤病变SUVmax的特征,为临床鉴别诊断提供依据.方法 CT或MRI发现的多发骨破坏患者119例,其中71例PET/CT检查后行病理检查,男40例,女31例;年龄37～87岁,平均61-3岁.病理确诊骨髓瘤21例,骨转移瘤41例.测量骨髓瘤和骨转移瘤每个骨病变的SUVmax并进行比较,采用ROC曲线获得鉴别诊断的分界点.采用单因素方差分析比较不同形态学特征(溶骨性和成骨性)骨转移瘤与骨髓瘤SUVmax的差异.结果 PET/CT在骨髓瘤病例中共检出315个病灶,在骨转移瘤病例中共检出684个病灶.骨髓瘤病灶SUVmax(3.42±1.96)值明显低于转移瘤病灶(7.03±4.15).SUVmax值为4.45时,鉴别骨髓瘤和骨转移瘤的敏感性和特异性分别为80.4%和72.4%.溶骨性骨转移瘤病灶SUVmax值(8.02±4.85)明显高于成骨性骨转移瘤(4.79±2.61)和骨髓瘤(3.37±1.92),而成骨性骨转移瘤与骨髓瘤病灶的SUVmax值差异无统计学意义(P>0.05).结论 PET/CT对未知原发灶的多发性骨破坏患者骨髓瘤与骨转移瘤的鉴别诊断具有潜在的价值,多发性骨破坏病灶SUVmax值较低和溶骨性破坏可提示骨髓瘤.
목적 회고성분석미지원발조적다발성골파배환자PET/CT현상중골수류여골전이류병변SUVmax적특정,위림상감별진단제공의거.방법 CT혹MRI발현적다발골파배환자119례,기중71례PET/CT검사후행병리검사,남40례,녀31례;년령37～87세,평균61-3세.병리학진골수류21례,골전이류41례.측량골수류화골전이류매개골병변적SUVmax병진행비교,채용ROC곡선획득감별진단적분계점.채용단인소방차분석비교불동형태학특정(용골성화성골성)골전이류여골수류SUVmax적차이.결과 PET/CT재골수류병례중공검출315개병조,재골전이류병례중공검출684개병조.골수류병조SUVmax(3.42±1.96)치명현저우전이류병조(7.03±4.15).SUVmax치위4.45시,감별골수류화골전이류적민감성화특이성분별위80.4%화72.4%.용골성골전이류병조SUVmax치(8.02±4.85)명현고우성골성골전이류(4.79±2.61)화골수류(3.37±1.92),이성골성골전이류여골수류병조적SUVmax치차이무통계학의의(P>0.05).결론 PET/CT대미지원발조적다발성골파배환자골수류여골전이류적감별진단구유잠재적개치,다발성골파배병조SUVmax치교저화용골성파배가제시골수류.
Objective To conduct a comparison of the standardized uptake value (SUV) of positron emission tomography/computed tomography (PET/CT) in myeloma and multiple bone metastasis disease. Methods A total of 119 patients with osteolysis were analyzed. There were 40 males and 31 females, with the mean age of 61.3 years. There were myelomas in 21 patients bone metastases diease in 41 patients,confirmed by histological section. Lesions of meyloma and bone metastasis disease were calculated. Feasible cutoff values of differentiation were determined by using the receiver operating characteristic (ROC) curve based positive test. A Comparion of the SUVmax between the multiple bone metastasis disease and myeloma was performed. Restlts PET/CT identified increased FDG uptake in 315 lesions in patients with myeloma, and 684 lesions in patients with metastases. SUVmax of myelomas were lower than metastastic lesions. The value of 4.45 had been proved to be appropriate in the differentiation of myeloma and multiple bone metastasis disease, the diagnostic sensitivity and specificity was 80.4% and 72.49b respectively. The SUVmax of osteolystic metastastic lesions were significantly higher than that of osteogenic metastastic lesions and lesions of myeloma, but no difference was found between the osteogenic metastastic lesions and lesions of myeloma. Conclusion FDG-PET/CT had potential value in the differentiation of myeloma and multiple bone metastasis diseases. Low SUVmax and uncertainty of origin suggested myeloma.