CAJ | 학술논문

目的比较18F-FDG PET/CT和大范围弥散磁共振成像(DWI)对非霍奇金淋巴瘤(NHL)骨髓浸润的诊断价值.方法对79例初诊且病理证实NHL患者进行PET/CT、大范围DWI、骨髓病理检查,以骨髓病理检查作为金标准,对比PET/CT与大范围DWI对淋巴瘤骨髓浸润诊断的灵敏度、特异度、准确性、阳性预测率、阴性预测率,并分析各部位、各亚型NHL骨髓浸润的情况.结果 79例NHL患者中,骨髓病理检查共检出骨髓浸润25例(57处骨髓);PET/CT显示22例患者(56处骨髓)PDG代谢增高;大范围DWI显示25例患者(58处骨髓)呈异常高信号灶.PET/CT诊断骨髓浸润的灵敏度、特异度、准确率、阳性预测值、阴性预测值分别为80.0％、96.3％、91.1％、90.9％、91.2％,而大范围DWI检查分别为84.0％、92.6％、89.9％、84.0％、92.6％.通过ROC曲线比较,PET/CT的Az值为0.911,大范围DWI的Az值为0.883,两者之间差异无统计学意义(P＞0.05).PET/CT及大范围DWI检测结果示:侵袭性NHL骨髓浸润率分别为30.4％(21/69)、33.3％(23/69),高于惰性NHL骨髓浸润率[10.0％(1/10)、20.0％(2/10)](P＜0.05).结论 PET/CT、大范围DWI均对NHL骨髓浸润有较高的诊断价值.PET/CT、大范围DWI及骨髓病理检查三种方法联合应用,可提高骨髓浸润的检出率.
목적 비교18F-FDG PET/CT화대범위미산자공진성상(DWI)대비곽기금림파류(NHL)골수침윤적진단개치.방법 대79례초진차병리증실NHL환자진행PET/CT、대범위DWI、골수병리검사,이골수병리검사작위금표준,대비PET/CT여대범위DWI대림파류골수침윤진단적령민도、특이도、준학성、양성예측솔、음성예측솔,병분석각부위、각아형NHL골수침윤적정황.결과 79례NHL환자중,골수병리검사공검출골수침윤25례(57처골수);PET/CT현시22례환자(56처골수)PDG대사증고;대범위DWI현시25례환자(58처골수)정이상고신호조.PET/CT진단골수침윤적령민도、특이도、준학솔、양성예측치、음성예측치분별위80.0％、96.3％、91.1％、90.9％、91.2％,이대범위DWI검사분별위84.0％、92.6％、89.9％、84.0％、92.6％.통과ROC곡선비교,PET/CT적Az치위0.911,대범위DWI적Az치위0.883,량자지간차이무통계학의의(P＞0.05).PET/CT급대범위DWI검측결과시:침습성NHL골수침윤솔분별위30.4％(21/69)、33.3％(23/69),고우타성NHL골수침윤솔[10.0％(1/10)、20.0％(2/10)](P＜0.05).결론 PET/CT、대범위DWI균대NHL골수침윤유교고적진단개치.PET/CT、대범위DWI급골수병리검사삼충방법연합응용,가제고골수침윤적검출솔.
Objective To compare the diagnostic value of 1SF-flurodeoxyglueose-positron emission tomography/computed tomography (18F-FDG PET/CT) and large-scale diffusion weighted imaging (DWI) for evaluation of non-Hodgkin lymphoma (NHL) bone marrow (BM) infiltration.Methods A total of 79 patients with pathologically diagnosed NHL underwent 1SF-FDG PET/CT,largescale DWI and BM pathological examination.BM examination as the “gold standard”,the performance (the sensitivity,specificity,accuracy,positive and negative predictive value) of 18F-FDG PET/CT and largescale DWI for evaluation of BM infiltration was compared and the risk of BM infiltration of different subtypes and sources of NHL was analyzed.Results 25 of 79 cases were diagnosed as BM infiltration by pathological examination with 57 BM sites.Abnormal high BM metabolisms were identified in 22 cases with 56 BM sites by 18F-FDG PET/CT and 25 cases with 58 BM sites by large-scale DWI.The sensitivity,specificity,accuracy,positive and negative predictive value of 18F-FDG PET/CT were 80.0％,96.3％,91.1％,90.9％,91.2％,respectively.And they were 84.0％,92.6％,89.9％,84.0％,and 92.6％ by large-scale DWI,respectively.A receiver operating characteristic (ROC) analysis demonstrated that there was no statistical difference in 18F-FDG PET/CT and large-scale DWI (P＞ 0.05).The area under ROC curve for 18F-FDG PET/CT and large-scale DWI were 0.911 and 0.883 respectively.The incidences of BM infiltration in aggressive NHL patients by 18F-FDG PET/CT (21/69,30.4％) and large-scale DWI (23/69,33.3％) were higher than those (PET/CT:10.0％; large-scale DWI:20.0％; P＞0.05) in indolent NHL patients.Conclusion 18F-FDG PET/CT and large-scale DWI had important clinical value in diagnosing BM infiltration of NHL.A combination of 18F-FDG PET/CT,large-scale DWI and pathological examination could improve the positive rate of BM infiltration in NHL.