CAJ | 학술논문

目的探讨18 F-FDG PET/CT全身显像在自身免疫性胰腺炎(AIP)诊断及全身评估中的价值.方法回顾性分析2010年8月至2013年2月长海医院核医学科行18F-FDG PET/CT全身检查的20例AIP患者的临床及FDG PET/CT影像资料,重点分析胰腺及全身病变的形态及代谢特征.结果 20例AIP患者中男性17例,女性3例,平均年龄60岁.18例主要临床表现为腹部疼痛或不适,黄疸,反复脂肪泻.2例为体检发现.血清IgG水平升高15例次,血清IgG4升高17例次,血CA19-9升高8例次.PET/CT显示20例患者胰腺病灶FDG摄取均明显增高,最大标准摄取值(SUVmax)为5.09±2.10(2.71～ 11.88),其中16例早期SUVmax为5.14±2.25,延迟扫描后SUVmax达6.23±2.77,平均滞留指数(RI)为21.20％.分型:弥漫型12例,局限型3例,混合型4例,多灶型1例.20例患者中19例发现胰腺外病灶,其中8例次合并胆管炎症,6例次涎腺肿大、代谢增高,13例次伴有1处以上的高代谢肿大淋巴结,8例次合并肺部间质性炎症或结节,11例次男性患者前列腺呈现“八字形”高摄取,3例次合并十二指肠乳头肿大伴代谢增高,2例次合并腹膜后纤维化,2例次合并溃疡型结肠炎,节段性结肠壁增厚伴FDG摄取增高.结论 18F-FDG PET/CT检查不仅可以很好地显示AIP的胰腺病变的形态、代谢特征,且能显示胰腺外器官的受累情况,有助于AIP的及时准确诊断及全身评估.
목적 탐토18 F-FDG PET/CT전신현상재자신면역성이선염(AIP)진단급전신평고중적개치.방법 회고성분석2010년8월지2013년2월장해의원핵의학과행18F-FDG PET/CT전신검사적20례AIP환자적림상급FDG PET/CT영상자료,중점분석이선급전신병변적형태급대사특정.결과 20례AIP환자중남성17례,녀성3례,평균년령60세.18례주요림상표현위복부동통혹불괄,황달,반복지방사.2례위체검발현.혈청IgG수평승고15례차,혈청IgG4승고17례차,혈CA19-9승고8례차.PET/CT현시20례환자이선병조FDG섭취균명현증고,최대표준섭취치(SUVmax)위5.09±2.10(2.71～ 11.88),기중16례조기SUVmax위5.14±2.25,연지소묘후SUVmax체6.23±2.77,평균체류지수(RI)위21.20％.분형:미만형12례,국한형3례,혼합형4례,다조형1례.20례환자중19례발현이선외병조,기중8례차합병담관염증,6례차연선종대、대사증고,13례차반유1처이상적고대사종대림파결,8례차합병폐부간질성염증혹결절,11례차남성환자전렬선정현“팔자형”고섭취,3례차합병십이지장유두종대반대사증고,2례차합병복막후섬유화,2례차합병궤양형결장염,절단성결장벽증후반FDG섭취증고.결론 18F-FDG PET/CT검사불부가이흔호지현시AIP적이선병변적형태、대사특정,차능현시이선외기관적수루정황,유조우AIP적급시준학진단급전신평고.
Objective To investigate the role of 18 F-fluorodeoxyglucose positron emission tomography/ computed tomography (18 F-FDG PET/CT) in diagnosing of autoimmune pancreatitis (AIP) and systemic evaluation.Methods Twenty AIP patients who underwent 18F-FDG PET/CT whole-body examination in Department of Nuclear Medicine,Changhai Hospital from August 2010 to February 2013 were analyzed retrospectively.The morphology and metabolic characteristics of pancreatic and extra-pancreatic lesions (EPLs) were analyzed.Results The mean age of 20 AIP patients (17 male and 3 female) was 60 years old.The main clinical features were abdominal pain or discomfort,jaundice,and repeated steatorrhea.Two patients were detected during routine health check-up.Elevated serum IgG levels were found in 15 cases,and elevated serum IgG4 was detected in 17 cases,and elevated serum CA19-9 was found in 8 cases.The maximumstandardized uptake value (SUVmax) of the pancreas of the 20 patients were significantly increased,and the SUVmax was 5.09 ± 2.10 (2.71 ～ 11.88),and it was 5.14 ± 2.25 in early scanning,and it increased to 6.23 ±2.77 after delayed scanning,and the retention index was 21.20％.Morphologically,diffuse type was found in 12 cases,segmental enlargement type in 3 cases,mixed type in 4 cases,multifocal enlargement in 1 case.Extra-pancreatic lesions were observed in 19 cases,which including cholangitis (n =8) ; sialosis with increased metabolism (n =6) ; lymphadenectasis with increased FDG uptake (n =13) ; interstitial pneumonia or nodule (n =8) ; inverted "V" shaped high FDG uptake foci in prostate (n =11) ; enlarged duodenal papilla with increased metabolism (n =3) ; retroperitoneal fibrosis (n =2) ; ulcerative colitis with segmental increased metabolism (n =2).Conclusions 18 F-FDG PET/CT can show the morphology and metabolic characteristics of pancreatic lesions of AIP,and detect the extra-pancreatic lesions as well.It helps in diagnosis and wholebody evaluation of AIP.