赵梅莘,张卫方.18F-FDG-PET/CT诊断淋巴瘤化疗性肺损伤[J].中国医学影像技术,2017,33(1):40~43
18F-FDG-PET/CT诊断淋巴瘤化疗性肺损伤
18F-FDG-PET/CT in diagnosis of chemotherapy-induced lung injury in patients with lymphoma
投稿时间:2016-06-22  修订日期:2016-11-04
DOI:10.13929/j.1003-3289.201606110
中文关键词:  正电子发射型体层摄影术  体层摄影术,X线计算机  淋巴瘤  化疗性肺损伤
英文关键词:Positron-emission tomography  Tomography,X-ray computed  Lymphoma  Chemotherapy-induced lung injury
基金项目:
作者单位E-mail
赵梅莘 北京大学第三医院核医学科, 北京 100191  
张卫方 北京大学第三医院核医学科, 北京 100191 13681358745@126.com 
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中文摘要:
      目的 探讨18F-FDG-PET/CT显像诊断淋巴瘤化疗性肺损伤的价值。方法 回顾性分析既往因淋巴瘤化疗评估接受PET/CT检查并发现肺内新发病灶的患者,筛选最终临床诊断为化疗性肺损伤的病例,分析后其临床及影像学特点。结果 共10例患者诊断为化疗性肺损伤。涉及的化疗方案包括4例R-CHOP,2例R-EPOCH,1例BEACOP,1例R-BEACOP,1例R-GDP及1例克拉屈滨。5例患者无明显症状。PET/CT表现:2例患者累及单肺、8例双肺受累。肺内损伤主要为磨玻璃密度影、网格影、斑片影及实变。病变区域最大标准化摄取比值(SUVmax)为1.33~4.83,患者病灶SUVmax/纵隔血池SUVmean为0.88~4.09。患者接受停药及激素治疗后复查CT,肺内病变均明显好转。结论 18F-FDG-PET/CT可早期发现尚未出现临床症状的肺损伤,对诊断淋巴瘤化疗性肺损伤有价值。
英文摘要:
      Objective To analyze the diagnostic value of 18F-FDG-PET/CT on lung injury after chemotherapy in patients with lymphoma. Methods Patients with lymphoma received PET/CT for assessment after chemotherapy and presented with new-onset pulmonary lesions were analyzed retrospectively. The patients clinically diagnosed as chemotherapy-induced lung injury were enrolled in study and their clinical and imaging characteristics were evaluated. Results Ten patients were finally diagnosed as chemotherapy-induced lung injury. The chemotherapy regimens included 4 cases of R-CHOP, 2 cases of R-EPOCH, 1 case of BEACOP, 1 case of R-BEACOP, 1 case of R-GDP and 1 case of cladribine. Five patients had no symptoms. PET/CT scans revealed multiple signs such as ground glass-like changes, reticular pattern, patchy shadows and consolidation. Eight patients showed bilateral lung injury and 2 showed unilateral lung injury. FDG uptake was mild to moderate with SUVmax from 1.33 to 4.83, standardized uptake ratio-blood pool (SUR-BP) was 0.88 to 4.09. Following treatment with temporary drug withdrawal and intravenous corticosteroids, CT showed the pulmonary lesions were obviously relieved in all patients. Conclusion PET/CT scan might be able to detect pulmonary drug toxicity in asymptomatic patients and had value in diagnosis of chemotherapy-induced lung injury.
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