正电子发射断层扫描中胃内（18）F-2-脱氧-2-氟葡萄糖积聚的意义

Significance of (18)F-2-deoxy-2-fluoro-glucose accumulation in the stomach on positron emission tomography.

作者信息

Takahashi Hiroshi, Ukawa Kunio, Ohkawa Nobuhiko, Kato Kaoru, Hayashi Yuuko, Yoshimoto Kazuhito, Ishiyama Akiyoshi, Ueki Nobuko, Kuraoka Kensuke, Tsuchida Tomohiro, Yamamoto Yorimasa, Chino Akiko, Uragami Naoyuki, Fujisaki Junko, Igarashi Masahiro, Fujita Rikiya, Koyama Masamichi, Yamashita Takashi

机构信息

Department of Cancer Screening Center, Cancer Institute Hospital of Japanese Foundation for Cancer Research, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.

出版信息

Ann Nucl Med. 2009 Jun;23(4):391-7. doi: 10.1007/s12149-009-0255-3. Epub 2009 Apr 28.

DOI:10.1007/s12149-009-0255-3

PMID:19399579

Abstract

OBJECTIVE

To explain the accumulation of (18)F-2-deoxy-2-fluoro-glucose ((18)FDG) on positron emission tomography (PET) in the stomach and differences in its pattern, we focus on the accumulation pattern in association with endoscopic findings of the gastric mucosa and Helicobacter pylori (Hp) infection.

METHODS

Of 599 cases undergoing (18)FDG-PET examinations, we retrospectively analyzed the pattern of (18)FDG accumulation in the stomach, findings of upper gastrointestinal endoscopy, and Hp infection. The pattern of (18)FDG accumulation was classified into three groups: localized accumulation only in the fornix (Group A, 32 patients), diffuse accumulation throughout the entire stomach (Group B, 49 patients), and no accumulation (Group C, 191 patients).

RESULTS

Regarding the relation between Hp infection and (18)FDG accumulation, Hp infection was positive in 56.3% of Group A, 73.5% of Group B, and 24.1% of Group C, with significant differences (p < 0.001). Regarding the relation between (18)FDG accumulation and gastric mucosal inflammation, when Groups A and B were compared with Group C, nearly half of the cases in the former groups had papular redness with a significantly higher frequency of redness and erosion. Three cases found to have malignant tumor were limited to the former groups. One MALT lymphoma case was also found in the same group. Accumulation of (18)FDG largely corresponded to mucosal inflammation including superficial gastritis and erosive gastritis, and therefore the main cause of non-specific (18)FDG accumulation was considered to be inflammatory mucosa (mainly redness). The accumulation pattern was not associated with atrophic changes of the gastric mucosa or with Hp infection, but with mucosal inflammatory changes, including redness and erosion localized to the fornix.

CONCLUSIONS

Accumulation of (18)FDG in the stomach suggests a high probability of the presence of inflammatory change in the gastric mucosa forming a background for the development of cancer or malignant lymphoma, and thus requires further endoscopic examinations.

摘要

目的

为解释胃在正电子发射断层扫描（PET）中（18）F-2-脱氧-2-氟葡萄糖（（18）FDG）的积聚情况及其模式差异，我们重点关注与胃黏膜内镜检查结果及幽门螺杆菌（Hp）感染相关的积聚模式。

方法

在599例行（18）FDG-PET检查的病例中，我们回顾性分析了胃内（18）FDG的积聚模式、上消化道内镜检查结果及Hp感染情况。（18）FDG的积聚模式分为三组：仅在胃穹窿部局限性积聚（A组，32例患者）、全胃弥漫性积聚（B组，49例患者）和无积聚（C组，191例患者）。

结果

关于Hp感染与（18）FDG积聚的关系，A组中56.3%、B组中73.5%、C组中24.1%的患者Hp感染呈阳性，差异有统计学意义（p<0.001）。关于（18）FDG积聚与胃黏膜炎症的关系，将A组和B组与C组进行比较时，前两组近一半的病例有丘疹样发红，发红和糜烂的频率明显更高。发现的3例恶性肿瘤均局限于前两组。同一组中还发现1例黏膜相关淋巴组织淋巴瘤病例。（18）FDG的积聚在很大程度上与包括浅表性胃炎和糜烂性胃炎在内的黏膜炎症相对应，因此非特异性（18）FDG积聚的主要原因被认为是炎性黏膜（主要是发红）。积聚模式与胃黏膜萎缩性改变或Hp感染无关，而是与包括胃穹窿部局限性发红和糜烂在内的黏膜炎症改变有关。