PET/CT与磁共振灌注成像在脑胶质瘤分级诊断中的应用  

The application of PET/CT imaging and MR perfusion imaging in grading intracranial glioma

作　　者：胡裕效[1] 卢光明[2] 朱虹[1] 张宗军[2] 季学满[2] 孙传金[1] 

机构地区：[1]南京军区南京总医院核医学科,南京医学硕士210002 [2]南京军区南京总医院医学影像科,南京210002

出　　处：《医学研究生学报》2010年第1期67-71,共5页Journal of Medical Postgraduates

基　　金：南京军区医学科学技术研究"十一五"计划基金(06MA120)

摘　　要：目的不同级别的胶质瘤其临床进程、治疗方法、预后等情况有很大差异,对患者术前准确预测胶质瘤的级别十分重要。目前,利用18氟-脱氧葡萄糖(18F-fluorodeoxyglucose,18F-FDG)PET/CT显像和磁共振灌注成像(perfu-sion weighted imaging,PWI)进行脑胶质瘤的术前分级,被认为是一种大有希望的方法。文中探讨18F-FDG PET/CT显像与PWI在脑胶质瘤分级诊断中的作用。方法对18例疑诊为脑胶质瘤的患者在治疗前行18F-FDG PET/CT显像和PWI,分析18F-FDG PET/CT图像,计算出标准提取值(standardizad uptake value,SUV)、肿瘤白质比(lesion-to-white matterratio,L/W),磁共振灌注指标相对脑血容量(relative cerebral volume,rCBV)值由肿瘤与对侧正常脑白质的CBV相比后得出。分析SUV、L/W、rCBV这3个半定量指标在脑胶质瘤分级诊断中的优劣。结果18例患者中WHOⅡ级7例、Ⅲ级6例、Ⅳ级5例。SUV和rCBV半定量参数不能区分WHOⅡ级和Ⅲ级患者,L/W在上述3级患者间差异均有显著性统计学意义。结论18F-FDG PET/CT显像及PWI能提供常规MRI所不能获取的信息,在胶质瘤的分级诊断中均有一定作用,其中L/W可能具有一定优势。Objective Different grades of glioma lead to different clinical course, treatments and prognosis, thus it is important to predict histological grades of glioma preoperatively. ^18 F-FDG PET/CT imaging and MR perfusion imaging is considered a promising method to evaluate glioma, and the present study was to evaluated the contribution of ^18F-FDG PET/CT imaging and MR perfusion imaging in grading intracranial glioma. Methods Eighteen consecutive patients with suspected primary brain glioma underwent ^18F-FDG PET/CT scanning and MR perfusion scanning in our hospital. To evaluate the relative sensitivity among standardized uptake value （SUV） , L/W, and rCBV, the PET/CT imaging were analyzed, and the SUV and Lesion-to-white matter ratio （L/W） were calculated. The rCBV ratios of lesions were calculated relative to the region of interest （ROI） values in contra lateral normal white matter. Results Eighteen brain gliomas were confirmed by pathologic diagnosis, including 7 WHO Ⅱ tumors, 6 WHOm tumors, and 5 WHOIV tumors. SUV and rCBV could not differentiate between WHO Ⅱ tumor and WHO m tumor, however significant difference could be found among the three using L/W. Conclusion ^18F-FDG PET/CT imaging and MR perfusion imaging could offer more diagnostic information than conventional MRI. All of the three semiquantitative data offer some contribution in grading intracranial gliomas, and L/W might be the best one.

关 键 词：18氟-脱氧葡萄糖 正电子发射型计算机断层扫描/电子计算机体层摄影术 脑胶质瘤 磁共振灌注成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]