Abstract
目的探讨18F-FDG PET/CT的三种评价方法在弥漫大B细胞淋巴瘤（DLBCL）患者骨髓受累中的诊断价值。方法对2012年7月至2014年6月的77例初治DLBCL患者资料进行回顾性分析，所有患者均接受18F-FDG PET/CT显像、单侧髂骨骨髓穿刺活检。以骨髓穿刺活检组织病理学检查结果为参照，评价视觉比较法（髂骨骨髓FDG摄取高于正常肝脏组织）、骨髓最大标准摄取值（SUVmax）法（髂骨骨髓SUVmax≥2.5作为淋巴瘤骨髓受累的诊断阈值）、SUVmax比值法（髂骨骨髓SUVmax与正常肝脏组织SUVmax比值≥1作为淋巴瘤骨髓受累的诊断阈值）的诊断效能。结果①77例患者中男36例，女41例。Ann-Arbor分期Ⅰ、Ⅱ、Ⅲ、Ⅳ期者分别为5、8、7、57例。②视觉比较法的诊断敏感性为100.00%，特异性为80.00%，阳性预测值为48.00%，阴性预测值为100.00%。③骨髓SUVmax法的诊断敏感性为75.00%，特异性为92.31%，阳性预测值为64.29%，阴性预测值为95.24%。④SUVmax比值法的诊断敏感度为100.00%，特异性为90.77%，阳性预测值66.67%，阴性预测值100.00%。结论髂骨骨髓SUVmax与正常肝脏组织SUVmax比值≥1作为18F-FDG PET/CT的诊断阈值在DLBCL患者骨髓受累中具有良好的诊断价值。
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