目的探讨氟-18-脱氧葡萄糖(18F-FDG)PET/CT在胃淋巴瘤的诊断及疗效评价中的价值。资料和方法25例经病理确诊的胃淋巴瘤,男性19例,女性6例,年龄22~79岁;分为3组,Ⅰ组11例,仅在治疗前进行1次PET/CT显像;Ⅱ组5例,治疗前、后多次PET/CT显像;Ⅲ组9例,仅在治疗后进行PET/CT显像。结果将Ⅰ组、Ⅱ组16例胃淋巴瘤患者治疗前的PET/CT影像表现分为4型,6例胃壁弥漫性增厚伴FDG代谢显著增高(Ⅰ型);7例胃壁节段性增厚伴FDG代谢显著增高(Ⅱ型);2例胃壁局限性增厚伴FDG代谢增高(Ⅲ型);1例胃壁多发结节样增厚伴FDG代谢串珠样增高(Ⅳ型)。Ⅱ组5例PET/CT评价疗效,4例达完全缓解,1例达部分缓解。ⅢⅢ组9例中有5例PET/CT显像阴性,1例发现新生肺癌,3例发现淋巴结活性病灶。结论胃淋巴瘤的18F-FDGPET/CT影像以Ⅰ型、Ⅱ型表现为主;18F-FDGPET/CT能较全面、准确地评价胃淋巴瘤的治疗效果。
Purpose To explore the clinical value of 18F-FDG PET/CT in the diagnosis and therapeutic response evaluation of gastric lymphoma. Materials and Methods Twenty-five patients (19 males and 6 females, age 22~79 years) with endoscopic and surgical pathology proved gastric lymphoma were divided into three groups. Eleven patients in group I underwent PET/CT before treatment; five patients in group Ⅱ underwent PET/CT before and after treatment; nine patients in groupⅢ received PET/CT imaging only after treatment. Results In sixteen patients from groups I and Ⅱ receiving PET/CT before treatment, there were 4 types of gastric lymphoma. There were 6 with typeⅠ(diffuse thickened gastric wall with significantly high FDG uptake), 7 with type Ⅱ(segmental thickened gastric wall with significantly high FDG uptake), 2 with type Ⅲ(local thickened gastric wall with high FDG uptake) and 1 with type Ⅳ(multiple nodular thickened gastric wall with string-of-beads high FDG uptake). When evaluating therapeutic response in five patients after treatment in group Ⅱ, PET/CT showed 4 cases with complete remission and 1 case with partial remission. Of the nine patients receiving post-treatment PET/CT scan in group Ⅲ, 5 cases showed negative FDG uptake; 1 case showed high-uptake pulmonary neoplasm; 3 cases were found to have lymph nodes with high FDG uptake. Conclusions TypeⅠand type Ⅱ findings of gastric lymphoma are more often seen on PET/CT imaging. PET/CT can accurately evaluate the therapeutic response of gastric lymphoma.