ĐẶC ĐIỂM HÌNH ẢNH 18F-FDG-PET/CT VỚI MỘT SỐ THỂ MÔ BỆNH HỌC U LYMPHO ÁC TÍNH KHÔNG HODGKIN TẠI BỆNH VIỆN BẠCH MAI GIAI ĐOẠN 2017 - 2022=Features of 18F-FDG-PET/CT imaging with some histopathological types of non-Hodgkin's lymphoma at Bach Mai Hospital in the period 2017-2022

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Tác giả: Trọng Khoa Mai, CẩM Phương PhạM, Văn Thái Phạm, Thị HằNg Thiều

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Điện quang và Y học hạt nhân Việt Nam, 2024

Mô tả vật lý: tr.30-42

Bộ sưu tập: Metadata

ID: 487005

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Mục tiêu: Mô tả đặc điểm hình ảnh 18F-FDG-PET/CT và nhận xét mối tương quan của hình ảnh 18F-FDG-PET/CT với một số thể mô bệnh học u lympho ác tính không Hodgkin.Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang, hồi cứu kết hợp tiến cứu trên 286 bệnh nhân U lympho ác tính không Hodgkin mới được chẩn đoán và điều trị tại Bệnh viện Bạch Mai.Kết quả: Tổn thương hạch ở 84,3%, tổn thương ngoài hạch ở 54,5%. Bệnh nhân chỉ tổn thương hạch chiếm 45,5%, amidan (17,7%), lách (11,7%)
chỉ tổn thương ngoài hạch chiếm 15,7% và tổn thương hỗn hợp cả hạch và ngoài hạch chiếm 38,8%. Tổn thương ngoài hạch hay gặp là xương (chiếm 18,4%), vòm họng (8,5%), dạ dày (8,2%), hốc mũi (7,8%), phổi (5,3%), tuyến thượng thận (4,3%), đại trực tràng (3,9%), gan (3,7%), phần mềm (2,8%), não (2,1%). Tổn thương bulky gặp 22,7% và 19,3 % vị trí ngoài hạch. Có mối tương quan tuyến tính thuận giữ kích thước tổn thương và SUVmax ở hạch cổ, nách, trung thất, ổ bụng và bẹn vớihệ số tương quan r tương ứng là: 0,47
0,51
0,41
0,46 và 0,56. Có mối tương quan tuyến tính thuận giữa kích thước tổn thương và SUVmax ở amidan, vòm họng , mũi, dạ dày, đại trực tràng, gan, phổi và tuyến thượng thận với hệ số tương quan r tương ứng là: 0,60
0,44
0,38
0,64
0,86
0,54
0,44 và 0,78. Không có sự khác biệt về kích thước và SUVmax của tổn thương hạch và ngoài hạch và tỷ lệ u bulky phân nhóm ULAKH B lớn lan tỏa GCB và nonGCB. Nhóm ULAKH B tiến triển chậm so với tiến triển nhanh: có sự khác biệt kích thước hạch ổ bụng nhóm tiến triển nhanh cao hơn (p<
0,05)
có sự khác biệt giá trị SUVmax tổn thương hạch cổ, trung thất, ổ bụng, tổn thương ngoài hạch ở nhóm B tiến triển nhanh cao hơn có ý nghĩa thống kê với p<
0,05. Nhóm ULAKH dòng T: T ngoại vi, T/NK, T bất thục sản có sự khác biệt về kích thước, SUVmax tổn thương hạch cổ, tổn thương ngoài hạch, xương (với p<
0,05)
có khác biệt giữa nhóm T ngoại vi thấp hơn T bất thục sản về kích thước, SUVmax hạch nách, ổ bụng, bẹn (p<
0,05) và SUVmax hạch trung thất (p<
0,05). Nhóm có chỉ số Ki76 cao, trung bình, thấp có sự khác biệt về SUVmax ở tổn thương hạch cổ, bụng và ngoài hạch (p<
0,05) mặc dù không có sự khác biệt về kích thước tổn thương (p>
0,05).Kết luận: Nghiên cứu trên 286 bệnh nhân ULAKH: Tổn thương hạch chiếm 84,3%
Tổn thương ngoài hạch chiếm 54,5% (tổn thương hỗn hợp cả hạch và ngoài hạch chiếm 38,8%). Có mối tương quan tuyến tính thuận giữa kích thước tổn thương và SUVmax ở hạch và tổn thương ngoài hạch. Không có sự khác biệt về kích thước và SUVmax của tổn thương hạch và ngoài hạch và tỷ lệ u bulky, phân nhóm ULAKH B lớn lan tỏa GCB và nonGCB. Có sự khác biệt kích thước và giá trị maxSUV của tổn thương 1 số vị trí tại hạch và ngoài hạch ở nhóm ULAKH B tiến triển chậm so với tiến triển nhanh, Nhóm ULAKH dòng T, nhóm có chỉ số Ki67 cao.Objective: Description of 18F-FDG-PET/CT imaging characteristics and Comment on the correlation of 18F-FDG-PET/CT images with some histopathological types of non-Hodgkin's lymphoma.Methods: Cross-sectional, retrospective and prospective descriptive study in 286 patients with non-Hodgkin's lymphoma were newly diagnosed and treated at Bach Mai Hospital.Results: Lymph node involvement for 84.3%, extra-nodal lesions for 54.5%, tonsils (17.7%), spleen (11.7%). Patients only had lymph node lesions for 45.5%, only extranodal lesions accounted for 15.7% and mixed lymph node and extranodal lesions accounted for 38.8%. Common extranodal lesions are bone (18.4%), nasopharynx (8.5%), stomach (8.2%), nasal cavity (7.8%), lung (5.3%), adrenal gland (4.3%), colorectal (3.9%), liver (3.7%), soft tissue (2 0.8%), brain (2.1%). Bulky lesions in 22.7% lymph node locations, 19.3% extranodal location. There is a positive linear correlation between lesion size and SUVmax in cervical, axillary,mediastinal, abdominal and inguinal nodes with the corresponding correlation coefficient r: 0.47
0.51
0.41
0.46 and 0.56. There is a positive linear correlation between lesion size and SUVmax in tonsil, nasopharynx, nose, stomach, colorectal, liver, lung and adrenal gland with the corresponding correlation coefficient r: 0.60
0.44
0.38
0.64
0.86
0.54
0.44 and 0.78. There was no difference in size and SUVmax of lymph node and extranodal lesions and the proportion of bulky tumors in diffuse large B cells lymphoma’s subtypes GCB and nonGCB. B cells non Hodgkin lymphoma group progressed slowly compared to fast progress: there was a higher difference in the size of abdominal lymph nodes in the rapidly progressing group (p<
0.05)
There was a difference in SUVmax values of cervical, mediastinal, abdominal, and extra-nodal lesions in group B cells lymphoma that progressed faster with p<
0.05. T cells non Hodgkinlymphoma group: Peripheral T, T/NK, aplastic T have differences in size, SUVmax with cervical lymph node damage, extranodal injury, bone (with p<
0.05)
There was a difference between group T peripheral lower than T anaplastic in size, SUVmax axillary, abdominal, inguinal (p<
0.05) and SUVmax mediastinal lymph node (p<
0.05). The group with high, medium and low Ki76 index had a difference in SUVmax in cervical, abdominal and extra-nodal lesions (p<
0.05) although there was no difference in lesion size (p>
0.05).Conclusions: Study on 286 non Hodgkin lymphoma patients: lymphadenopathy in 84.3%
Extra-nodal lesions in 54.5% (mixed lesions of both lymph nodes and extra-nodals in 38.8%). There is a positive linear correlation between lesion size and SUVmax in lymph nodes and extranodal lesions. There was no difference in size and SUVmax of lymph node and extranodal lesions and the prevalence of bulky tumors, diffuse large B cells lymphoma subtypes GCB and nonGCB. There was a difference in size and maxSUV value of lesions at some sites in the lymph nodes and in extra-nodal nodes in the group with slow progression compared to the fast progression B cell group, the T cells group, the high ki67 group.

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