18F-FDG PET/CT 在一例无肺部疾病的多灶性骨骼结核中的应用及其在监测治疗反应中的潜在作用。

18F-FDG PET/CT in a case of multifocal skeletal tuberculosis without pulmonary disease and potential role for monitoring treatment response.

机构信息

From the *Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea; and †Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

出版信息

Clin Nucl Med. 2014 Nov;39(11):980-3. doi: 10.1097/RLU.0000000000000363.

DOI:10.1097/RLU.0000000000000363

PMID:24561689

Abstract

A 39-year-old man presented with left shoulder and interscapular pain. 99mTc-MDP bone scan demonstrated multiple active bone lesions including scapula, spines, ribs, and pelvis. Chest X-ray showed no active lung lesion, and MRI demonstrated infiltrative enhancing lesions in the T-spines and ribs, indicating skeletal metastasis. 18F-FDG PET/CT performed to search for hidden malignancy revealed multiple osteolytic lesions with intense FDG uptake, supporting metastasis. Tissue obtained from the T1 lesion showed no malignant cells but was positive for Mycobacterium tuberculosis. After 18 months of antituberculosis medication, follow-up 18F-FDG PET/CT showed complete normalization of FDG uptake in the skeletal lesions.

摘要

一位 39 岁男性出现左侧肩部和肩胛间疼痛。99mTc-MDP 骨扫描显示多个活跃的骨病变，包括肩胛骨、脊柱、肋骨和骨盆。胸部 X 光片未见活动性肺部病变，MRI 显示 T 脊柱和肋骨浸润性增强病变，提示骨骼转移。进行 18F-FDG PET/CT 以寻找隐匿性恶性肿瘤，发现多个溶骨性病变伴有强烈的 FDG 摄取，支持转移。从 T1 病变处获得的组织未显示恶性细胞，但结核分枝杆菌呈阳性。抗结核药物治疗 18 个月后，随访 18F-FDG PET/CT 显示骨骼病变中 FDG 摄取完全正常。