Goodin Geoffrey S, Shulkin Barry L, Kaufman Robert A, McCarville M Beth
Division of Diagnostic Imaging, Department of Radiological Sciences, MS 210, St. Jude Children's Research Hospital, 332 N Lauderdale St., Memphis, TN 38105-2794, USA.
AJR Am J Roentgenol. 2006 Oct;187(4):1124-8. doi: 10.2214/AJR.06.0171.
The purpose of this study was to characterize the anatomic appearance and metabolic activity of nonossifying fibromas, fibrous cortical defects, and cortical desmoids on PET/CT images.
Over a 14-month period, we identified eight nonossifying fibromas, four fibrous cortical defects, and two cortical desmoids in 330 children who underwent PET/CT for the evaluation of a known or suspected malignancy. CT, conventional radiography, MRI, or clinical follow-up was used to confirm the diagnoses of these fibroosseous lesions. Eleven of the 14 children underwent multiple PET/CT examinations; thus, 34 studies were included. The lesions showed variable metabolic activity as indicated by 18F-FDG uptake: 19 PET/CT examinations showed lesions with mild 18F-FDG uptake, eight showed moderate 18F-FDG uptake, and seven showed intense uptake. When PET reveals metabolically active osseous abnormalities in children who are at risk for bone metastases, benign fibroosseous lesions should be considered in the differential diagnosis before additional diagnostic procedures are undertaken. Benign fibroosseous lesions may be metabolically active and thus mimic metastatic osseous disease in children with underlying malignancies. Correlative CT or other anatomic imaging can confirm the benign nature of these lesions.
本研究的目的是在PET/CT图像上描述非骨化性纤维瘤、纤维性骨皮质缺损和骨皮质硬纤维瘤的解剖学表现及代谢活性。
在14个月的时间里，我们在330名因已知或疑似恶性肿瘤而接受PET/CT检查的儿童中，发现了8例非骨化性纤维瘤、4例纤维性骨皮质缺损和2例骨皮质硬纤维瘤。采用CT、传统X线摄影、MRI或临床随访来确诊这些纤维骨性病变。14名儿童中有11名接受了多次PET/CT检查；因此，共纳入34项研究。病变表现出18F-FDG摄取所提示的不同代谢活性：19次PET/CT检查显示病变有轻度18F-FDG摄取，8次显示中度18F-FDG摄取，7次显示强烈摄取。当PET显示有骨转移风险的儿童存在代谢活跃的骨异常时，在采取进一步诊断措施之前，鉴别诊断中应考虑良性纤维骨性病变。良性纤维骨性病变可能具有代谢活性，因此在有潜在恶性肿瘤的儿童中可能会模仿转移性骨病。相关的CT或其他解剖成像可以证实这些病变的良性性质。
