18FDGPET/CT在皮肌炎/多发性肌炎伴恶性肿瘤诊断中的应用

doi:10.13481/j.1671-587x.20160333

摘要/Abstract

摘要：

目的: 探讨18F-脱氧葡萄糖(¹⁸FDG)正电子发射计算机断层显像(PET)/计算机断层显像(CT)在皮肌炎(DM)/多发性肌炎(PM)伴恶性肿瘤中的影像特点,为DM/PM的诊断提供依据。方法: 收集2009—2015年北京协和医院收治的17例DM/PM并发肿瘤的患者和39例同期未并发肿瘤患者的临床资料和¹⁸FDGPET/CT影像资料,并进行分析。结果: 56例DM/PM患者中并发肿瘤17例,包括淋巴瘤5例(其中3例为T细胞淋巴瘤),肺癌7例,甲状腺癌、乳腺癌、宫颈癌、肝脏神经内分泌肿瘤和胸腺瘤各1例,肿瘤病灶的¹⁸FDG摄取较高,最大标准摄取值(SUVmax)为1.47~22.93(7.67±6.60)。全部患者中22例患者¹⁸FDGPET/CT显像示全身肌肉弥漫性摄取升高,肌肉的SUVmax为0.71~2.93(1.43±0.68),其中9例患者(40.91%)伴有恶性病变;26例患者¹⁸FDGPET/CT显像示局部肌肉摄取升高,肌肉的SUVmax为1.06~8.74(2.62±1.65),其中6例患者(23.08%)伴有恶性病变;8例患者的¹⁸FDGPET/CT显像示全身肌肉¹⁸FDG未见摄取升高,其中3例患者(37.50%)伴有恶性病变。15例并发间质性肺炎,其中2例患者(13.33%)伴有恶性病变。结论: 肿瘤相关性DM的¹⁸FDGPET/CT影像表现有一定特征性,其中全身肌肉弥漫性摄取升高者肿瘤发病率最高;对可疑DM/PM伴恶性肿瘤患者,¹⁸FDGPET/CT可以作为有效的辅助诊断方法。

关键词: 皮肌炎, 恶性肿瘤, 正电子发射计算机断层显像, ¹⁸F-脱氧葡萄糖, 体层摄影术, X线计算机

Abstract:

Objective: To investigate the image characteristics of ¹⁸F-fluorodeoxyglucose (¹⁸FDG) positron emission tomography and computer tomography(PET/CT) in the patients with dermatomyositis (DM) or polymyositis (PM)associated with malignancy,and to provide basis for the diagnosis of DM/PM. Methods: The clinical data of inpatients diagnosed with DM/PM during 2009 to 2015 in Peking Union Medical College Hospital were collected.The clinical manifestations and ¹⁸FDG PET/CT wholebody scan were analyzed in the 17 patients with DM/PM complicated with tumor and 39 patients with DM/PM without tumor. Results: Among 56 patients with DM/PM,17 patients were complicated with maglignant tumor; there were 5 patients with lymphoma, 7 patients with lung cancer, 1 patient with thyroid carcinoma, 1 patient with breast cancer,1 patient with cervical carcinoma, 1 patient with neuroendocrine tumor of liver,and 1 patient with thymoma.The maximal standard uptake value(SUVmax) of malignant lesions was 1.47-22.93(7.67±6.60).There was diffuse increase of ¹⁸FDG uptake in the muscles in 22 patients,and the SUVmax was 0.71-2.93(1.43±0.68); there were 9 patients(40.91%)associated with malignancies.There was local increase of ¹⁸FDG uptake in the muscles in 26 patients,and the SUVmax was 1.06-8.74(2.62±1.65). There were 6 patients(23.08%)associated with malignancies.There was normal level of ¹⁸FDG uptake in the muscles in 8 patients; There were 3 patients(37.50%)associated with malignancies. There was 15 patients with interstitial pneumonia,and 2 patients(13.33%)associated with malignancies. Conclusion: The ¹⁸FDG PET/CT image of tumor-associated DM/PM has the certain characteristics.The patients with diffuse increase of ¹⁸FDG uptake in the muscles have the highest incidence rate of tumor.¹⁸FDG-PET/CT may become an effective method of assisted diagnosis for the patients with suspected DM/PM.

Key words: dermatomyositis, malignant neoplasms, positron emission tomography, fluorine-18 fluoro-deoxyglucose, tomography,X-ray computed

中图分类号:

R445.5

刘洋, 程欣, 石希敏, 党永红, 刘宇, 刘小丽. ¹⁸FDGPET/CT在皮肌炎/多发性肌炎伴恶性肿瘤诊断中的应用[J]. 吉林大学学报(医学版), 2016, 42(03): 587-590.

LIU Yang, CHENG Xin, SHI Ximin, DANG Yonghong, LIU Yu, LIU Xiaoli. Application of ¹⁸FDG PET/CT in diagnosis of dermatomyositis or polymyositis associated with malignant tumor[J]. Journal of Jilin University Medicine Edition, 2016, 42(03): 587-590.

参考文献

[1] 银正民.北京肿瘤急症学[M].北京:人民卫生出版社,2000,615-616.

[2] Bohan A,Peter JB.Polymyositis and dermatomyositis[J].N Engl J Med,1975,292(7):344-347.

[3] Zampieri S,Valente M,Adami N,et al.Polymyositis,dermatomyositis and maligancy:A further in triguring link[J].Autoimmun Rev,2010,9(6):449-453.

[4] Maoz CR,Langevitz P,Livneh A,et al.High incidence of malignancies in patients with dermatomyositis and polymyositis:an 11-year analysis[J].Semin Arthritis Rheum,1998,27(5):319-324.

[5] Chen YJ,Wu CY,Huang YL,et al.Cancer risks of dermatomyositis and polymyositis:a nationwide cohort study in Taiwan[J].Arthritis Res Ther,2010,12(2):R70.

[6] 苟丽娟,苏金梅,赵岩,等.皮肌炎和多发性肌炎伴发肿瘤临床特点及文献回顾[J].中华临床免疫和变态反应杂志,2012,6(4):295-299.

[7] 邓紫玉,王云莉.皮肌炎/多发性肌炎合并恶性肿瘤 14 例临床分析[J].中国实用医药,2009,4(3):196-197.

[8] 谢红付,朱武.皮肌炎患者合并恶性肿瘤的临床分析[J].临床皮肤科杂志,2000, 29( 1) : 22-23.

[9] Suh KJ,Park JK,Cho S,et al.Dermatomyositis in a patient with cholangiocarcinoma detected by an [18F]-fluorodeoxyglucose positron emission tomography/computed tomography scan[J].Cancer Res Treat,2015,47(1):1-5.

[10] Jayanthi MR,Basher RK,Bhadada SK,et al.A case of adult dermatomyositis with calcinosis universalis[J].J Nucl Med,2014,29(4):278-279.

[11] Chung WS,Lin CL,Sung FC,et al.Increased risk of venous thromboembolism in patients with dermatomyositis/polymyositis:a nationwide cohort study[J].Thromb Res,2014,134(3):622-626.

[12] Tanaka S,Ikeda K,Uchiyama K,et al.[18 F]FDG uptake in proximal muscles assessed by PET/CT reflects both global and local muscular inflammation and provides useful information in the management of patients with polymyositis/dermatomyositis[J].Rheumatology(Oxford),2013,52(7):1271-1278.

[13] Dalakas MC.Pathogenesis and therapies of immunemediated myopathies [J].Autoimmun Rev,2012,11(3):203-206.

[14] Chandesris MO,Durand JM,Gamby T,et al.Dermatomyositis with cutaneous necrosis revealing a fallopian tube carcinoma[J].Rev Med Int,2005,26(6):508-510.

[15] Grau JM,Miro O,Pedrol E,et al.Interstitial lung disease related to dermatomyositis.Comparative study with patients without lung involvement[J].J Bheumatol,1996,23(11):1921-1926.

¹⁸FDGPET/CT在皮肌炎/多发性肌炎伴恶性肿瘤诊断中的应用

Application of ¹⁸FDG PET/CT in diagnosis of dermatomyositis or polymyositis associated with malignant tumor

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