CAJ | 학술논문

目的总结多发性周围神经病、脏器肿大、内分泌病变、M蛋白和皮肤病变(POEMS)综合征的18F-FDG PET/CT表现,探讨18F-FDG PET/CT在该病中的应用价值.方法 2008年10月至2013年2月间经临床证实的11例POEMS综合征患者[男7例,女4例,年龄49～73(58.5±8.4)岁],确诊前均行18F-FDG PET/CT显像.总结病例的PET/CT图像特征,观察病灶18F-FDG摄取情况.结果 11例患者均存在多发硬化性骨病变(141个):顶骨5个,肩胛骨8个,锁骨4个,肋骨16个,椎体64个,髂骨29个,坐骨6个,耻骨8个,肱骨1个;其中58个PET显像阳性,SUVmax为4.3±1.6.肝脏肿大者1例,脾脏肿大者3例,同时存在肝、脾肿大者2例;其中有3例肿大脾脏FDG摄取增高,SUVmax为3.2～4.1.5例患者多发淋巴结肿大,均可见FDG摄取增高,SUVmax为2.6～4.9.胸腔积液者1例,腹腔积液者3例,盆腔积液者3例,三者并存2例,且这2例合并存在皮下水肿,均未见异常18F-FDG摄取.结论 18F-FDG PET/CT可以同时发现POEMS综合征的骨损害、脏器肿大以及血管外水容量过负荷等多系统病变,其表现具有一定的特征性,能为临床进一步诊治提供依据.
목적 총결다발성주위신경병、장기종대、내분비병변、M단백화피부병변(POEMS)종합정적18F-FDG PET/CT표현,탐토18F-FDG PET/CT재해병중적응용개치.방법 2008년10월지2013년2월간경림상증실적11례POEMS종합정환자[남7례,녀4례,년령49～73(58.5±8.4)세],학진전균행18F-FDG PET/CT현상.총결병례적PET/CT도상특정,관찰병조18F-FDG섭취정황.결과 11례환자균존재다발경화성골병변(141개):정골5개,견갑골8개,쇄골4개,륵골16개,추체64개,가골29개,좌골6개,치골8개,굉골1개;기중58개PET현상양성,SUVmax위4.3±1.6.간장종대자1례,비장종대자3례,동시존재간、비종대자2례;기중유3례종대비장FDG섭취증고,SUVmax위3.2～4.1.5례환자다발림파결종대,균가견FDG섭취증고,SUVmax위2.6～4.9.흉강적액자1례,복강적액자3례,분강적액자3례,삼자병존2례,차저2례합병존재피하수종,균미견이상18F-FDG섭취.결론 18F-FDG PET/CT가이동시발현POEMS종합정적골손해、장기종대이급혈관외수용량과부하등다계통병변,기표현구유일정적특정성,능위림상진일보진치제공의거.
Objective To analyze the PET/CT findings in polyneuropathy,organomegaly,endocrinopathy,M-protein,and skin changes (POEMS) syndrome and explore its clinical value.Methods Eleven patients with POEMS syndrome (7 males,4 females; age range:49-73 years; mean age:(58.5±8.4) years) from October 2008 to February 2013 were retrospectively analyzed.All patients underwent 18F-FDG PET/CT scan.The image characteristics,including the abnormal 18 F-FDG uptake and SUVmax of the lesions,were analyzed.Results A total of 141 sclerotic bone lesions were found in 11 cases,including 5 lesions in parietal bones,8 in scapulas,4 in clavicles,16 in ribs,64 in vertebraes,29 in iliac bones,6 in ischiums,8 in pubic bones and 1 in humerus.Fifty-eight lesions had increased FDG uptake with the average SUVmax of 4.3±1.6.One case was with hepatomegaly,3 with splenomegaly,2 with hepatosplenomegaly and 5 with lymphadenopathy.Three patients with splenomegaly and 5 with lymphadenopathy were hypermetabolic,and the SUVmax was 3.2-4.1 and 2.6-4.9,respectively.One case was with bilateral pleural effusions,3 cases with seroperitoneum,3 cases with pelvic effusion and 2 cases with both polyserous effusions and subcutaneous dropsy.Conclusions Multisystem lesions,including bone damage,organomegaly,extravascular volume overload,could be detected by 18F-FDG PET/CT in the patients with POEMS syndrome.PET/CT is helpful for the diagnosis.