间皮瘤患者 ¹⁸F-FDG PET/CT 影像学表现及其在诊断中的应用.

赵爽言; 赵红光; 林秋玉; 焦本蒸; 林承赫

Objective: To analyze the imaging manifestations of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in the patients with pleural and peritoneal mesothelioma, and to enhance the diagnostic accuracy for this disease. Methods: A retrospective analysis was conducted on the 18F-FDG PET/CT imaging and immunohistochemical results of 22 patients confirmed pleural and peritoneal mesothelioma (21 malignant and 1 benign) by pathology. The imaging features and glucose metabolism characteristics were summarized. Results: The majority of the patients with malignant pleural mesothelioma presented with unilateral pleural diffuse thickening accompanied by increased radiotracer uptake, and the thicknesses were ranged from 1. 0 to 10. 6 cm and the average semi-quantitative maximum standard uptake value (SUVmax) was 10. 1. Over half of these patients also had a small amount of pleural effusion. The patients with malignant peritoneal mesothelioma mostly showed diffuse thickening of the peritoneum, omentum, and mesentery with increased radiotracer uptake, and the thicknesses were from 1. 2 to 6. 6 cm and the average SUVmax was 8. 4, and over half of these patients had a significant amount of abdominal ascites. Besides the primary sites, nodular, striated, and mass-like abnormal radiotracer uptakes were observed in other metastatic sites in 17 cases of malignant mesothelioma, suggesting metastasis, and the average SUVmax was 7. 4, predominantly surrounding lymph node metastasis. Bone and muscle metastases were visible in the patients with malignant pleural mesothelioma, while no such metastasis were seen in those with malignant peritoneal mesothelioma. One patient with benign pleural mesothelioma presented with bilateral pleural diffuse thickening approximately 3. 5 cm thick, without significant abnormal radiotracer uptake and with a minor pleural effusion. Conclusion: The 18F-FDG PET/CT imaging manifestations of pleural and peritoneal mesothelioma exhibit the distinctive characteristics. The mode and thickness of pleural and peritoneal thickening, the presence and degree of 18F-fluorodeoxyglucose uptake, can preliminarily differentiate between benign and malignant mesothelioma, thus providing valuable references for the early clinical diagnosis of mesothelioma. PET/CT based on whole-body imaging can determine whether there are other sites of metastasis, which is helpful for clinical staging.

POSITRON emission tomography; LYMPHATIC metastasis; COMPUTED tomography; GLUCOSE metabolism; MESOTHELIOMA; PLEURA diseases

Journal of Jilin University (Medicine Edition), 2024, Vol 50, Issue 4, p1150

1671-587X

Academic Journal

10.13481/j.1671-587X.202404031