CAJ | 학술논문

目的探讨继发性噬血细胞性淋巴组织细胞增多症(sHLH)的18 F-FDG PET/CT显像特点.方法回顾性分析南京医科大学第一附属医院2008年1月至2012年6月初诊的31例(男18例,女13例,平均年龄42岁)sHLH患者临床资料及18F-FDG PET/CT显像资料,根据病因将患者分为肿瘤相关HLH(MAHLH)组(13例)、感染相关HLH(IAHLH)组(13例)及风湿病相关HLH(RAHLH)组(5例),分别统计各组病灶FDG摄取情况和SUVmax.采用单因素方差分析及两样本￡检验对各组SUV max进行比较.结果 23例患者脾肿大合并18F-FDG摄取增高,RAHLH组、IAHLH组及MAHLH组对应例数分别为4、9和10例,对应脾脏SUVmax分别为3.16±0.61、5.67±3.37和6.04±3.06,差异无统计学意义(F=1.051,P＞0.05).15例淋巴结增大合并18F-FDG摄取增高:其中IAHLH组(8例)与MAHLH组(7例)肿大淋巴结SUVmax分别为5.35±1.69和10.14±5.24,差异有统计学意义(t=-2.456,P＜0.05).17例骨髓18F-FDG摄取增高:其中RAHLH组1例,SUVmax为4.6;IAHLH组(7例)与MAHLH组(9例)骨髓SUVmax分别为5.31±2.05和6.36±3.71(t =-0.670,P＞0.05).10例肝脏体积增大的患者中,4例合并18F-FDG摄取增高,SUVmax为4.9～10.2.MAHLH组、IAHLH组及RAHLH组SUVmaw分别为8.15±4.38、5.62±2.45和3.02±1.31,MAHLH最高(F=9.123,t=2.562、5.236、3.030,均P＜0.05).结论 RAHLH多表现为脾脏肿大伴18F-FDG摄取轻度增高,IAHLH和MAHLH多表现为脾脏肿大,侵犯淋巴结及骨髓;且MAHLH FDG摄取最高.上述18F-FDG PET/CT显像特点有助于对该病的准确诊断.
목적 탐토계발성서혈세포성림파조직세포증다증(sHLH)적18 F-FDG PET/CT현상특점.방법 회고성분석남경의과대학제일부속의원2008년1월지2012년6월초진적31례(남18례,녀13례,평균년령42세)sHLH환자림상자료급18F-FDG PET/CT현상자료,근거병인장환자분위종류상관HLH(MAHLH)조(13례)、감염상관HLH(IAHLH)조(13례)급풍습병상관HLH(RAHLH)조(5례),분별통계각조병조FDG섭취정황화SUVmax.채용단인소방차분석급량양본￡검험대각조SUV max진행비교.결과 23례환자비종대합병18F-FDG섭취증고,RAHLH조、IAHLH조급MAHLH조대응례수분별위4、9화10례,대응비장SUVmax분별위3.16±0.61、5.67±3.37화6.04±3.06,차이무통계학의의(F=1.051,P＞0.05).15례림파결증대합병18F-FDG섭취증고:기중IAHLH조(8례)여MAHLH조(7례)종대림파결SUVmax분별위5.35±1.69화10.14±5.24,차이유통계학의의(t=-2.456,P＜0.05).17례골수18F-FDG섭취증고:기중RAHLH조1례,SUVmax위4.6;IAHLH조(7례)여MAHLH조(9례)골수SUVmax분별위5.31±2.05화6.36±3.71(t =-0.670,P＞0.05).10례간장체적증대적환자중,4례합병18F-FDG섭취증고,SUVmax위4.9～10.2.MAHLH조、IAHLH조급RAHLH조SUVmaw분별위8.15±4.38、5.62±2.45화3.02±1.31,MAHLH최고(F=9.123,t=2.562、5.236、3.030,균P＜0.05).결론 RAHLH다표현위비장종대반18F-FDG섭취경도증고,IAHLH화MAHLH다표현위비장종대,침범림파결급골수;차MAHLH FDG섭취최고.상술18F-FDG PET/CT현상특점유조우대해병적준학진단.
Objective To summarize the imaging manifestations of 18F-FDG PET/CT in patients with secondary hemophagocytic lymphohistiocytosis (sHLH).Methods From January 2008 to June 2012,31 patients (18 males,13 females,average age:42 years) with sHLH were enrolled.All patients were divided into 3 groups:malignancy associated HLH (MAHLH) group (n =13),infection associated HLH (IAHLH) group (n =13) and rheumatosis associated HLH (RAHLH) group (n =5).They all underwent 18F-FDG PET/CT and SUVmax of lesions in each group was calculated.One-way analysis of variance and two-sample t test were used to analyze the SUVmax.Results Twenty-three patients were found splenomegaly with high FDG uptake,including 4 RAHLH patients,9 IAHLH patients and 10 MAHLH patients.The splenetic FDG uptake values (SUVmax) of RAHLH,IAHLH and MAHLH groups were 3.16±0.61,5.67±3.37 and 6.04±3.06,respectively (F=1.051,P＞0.05).The SUVmax of enlarged lymph nodes in IAHLH (n=8) and MAHLH groups (n =7) was 5.35± 1.69 and 10.14±5.24,respectively (t =-2.456,P＜0.05).Increased uptake in bone marrow was found in 17 patients,including 1 RAHLH patient,7 IAHLH patients and 9 MAHLH patients.The SUVmax of bone marrow in IAHLH and MAHLH patients was 5.31±2.05 and 6.36± 3.71 respectively (t=-0.670,P＞0.05).There were 10 cases of hepatomegaly,but only 4 of them had intense FDG uptake (SUVmax 4.9-10.2).The SUVmax of RAHLH,IAHLH and MAHLH groups was 3.02± 1.31,5.62±2.45 and 8.15±4.38,respectively (F=9.123,t=2.562,5.236,3.030,all P＜0.05).Conclusions RAHLH mostly showed splenomegaly with high FDG uptake,IAHLH and MAHLH both showed splenomegaly with lymph node and bone marrow invasion.The SUVmax of MAHLH was the highest.18F-FDG PET/CT imaging manifestations of sHLH may be helpful to improve the diagnostic accuracy.