18F-FDG PET/CT诊断腹膜后纤维化

Abstract

目的 探讨18F-FDG PET/CT诊断腹膜后纤维化(RPF)的价值.方法 回顾性分析因RPF接受18F-FDGPET/CT检查的12例患者,分析其病灶形态、分布范围和葡萄糖代谢活性最大标准摄取比值(SUVmax).结果 12例患者中,7例为初诊患者,5例为治疗后患者.7例初诊RPF患者中4例为继发性,病因分别为IgG4相关疾病、乳腺癌和前列腺癌.12例患者均可见腹主动脉和/或髂血管旁软组织密度病灶,91.67％(11/12)患者可见输尿管受累.初诊RPF患者腹膜后病灶SUVmax (4.21±1.76)显著高于治疗后患者(1.46士0.25;P＜0.05).依据PET/CT检查结果,3例有代谢活性病灶的特发RPF患者接受激素和/或他莫昔芬等免疫抑制治疗,4例具有活性病灶的继发RPF患者接受针对病因治疗;5例治疗后患者,3例继续当前激素维持剂量治疗,2例未接受其他治疗.结论 PET/CT可用于评价RPF病灶活性和分布范围.

Objective To explore the value of 18F-FDG PET/CT in diagnosis of retroperitoneal fibrosis (RPF).Methods Totally 12 RPF patients underwent 18 F-FDG PET/CT scanning,and the characteristics of metabolic activity,distribution of retroperitoneal lesions and maximum standardized uptake value (SUVmax) were analyzed retrospectively.Results Among 12 patients,7 were initial evaluation patients,5 were post-treatment patients.Of 7 initial evaluation patients,there were 4 patients with secondary RPF,including prostate carcinoma,breast cancer and IgG4-related disease.Retroperitoneal mass isodense with muscle surrounding the abdominal aorta or the iliac arteries were found in 12 patients,and ureteral involvement were found in 11 paients (11/12,91.67％).SUVmax in initial evaluation patients (4.21±1.76) was higher than that in patients after treatment (1.46±0.25,P＜0.05).According to PET/CT,3 idiopathic RPF patients as initial evaluation with high metabolic activity lesions received immunosuppressive therapy including corticosteroids and tamoxifen,and 4 secondary RPF patients with high metabolic activity lesions received treatment based on causes.Among 5 post-treatment patients,3 continued to accept current corticosteroids maintenance dose,while 2 did not receive any other treatment.Conclusion PET/CT may be used to evaluate the activity and extension of lesions in patients with RPF.