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神经淋巴瘤病的^18F-FDGPET/CT显像：1例报告并文献复习
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Journal Article
神经淋巴瘤病的^18F-FDGPET/CT显像：1例报告并文献复习
2016
Overview
目的通过1例神经淋巴瘤病（NL）患者的诊断及文献复习,总结18F-氟代脱氧葡萄糖（18F-FDG）正电子发射计算机断层显像（PET/CT）对NL的诊断价值。方法介绍1例经病理证实的弥漫大B细胞淋巴瘤伴周围神经病患者的临床表现和18F-FDG PET/CT显像结果,与传统影像学检查手段MRI和CT相比较,并结合既往文献进行复习。结果患者为38岁女性,因＂左胸背疼痛2个月＂就诊,胸椎增强MRI检查示胸4椎体左侧附件、左侧第5后肋骨质破坏,不排除肿瘤可能。18F-FDG PET/CT示胸4、5椎体左侧椎间孔区根块状放射性摄取增高影。病灶沿着左侧第5肋骨肋间神经呈束带状、短条状放射性摄取增高,胸骨左旁第2前肋间可见一类圆形放射性摄取增高灶。后者穿刺活检病理示弥漫大B细胞淋巴瘤（A型）。病变累及第4、5胸椎左侧神经根及左侧第5肋间神经,临床诊断为NL。经对症化疗后复查18F-FDG PET/CT,原异常放射性浓聚影消失。文献复习也显示PET/CT较MRI及CT有较高的阳性显示率,能更好地反映全身情况,对早期诊断NL有所帮助。结论 18F-FDG PET/CT是一种早期诊断NL有效和敏感的检查方法,特别是在患者有恶性血液病史,临床出现周围神经症状,其他检查手段阴性的情况下。与MRI等传统影像学检查手段相比,18F-FDG PET/CT能更直观地反映NL的病情程度,并准确反映受累神经数目、范围、病灶大小、形态和肿瘤活性,可为穿刺活检提供重要信息。
