^(11)C-Met PET与MRI影像融合技术在胶质瘤术前评价和术中导航中的应用价值  

Application of intergration of MRI and ^(11)C-methionine PET in preoperative assessment and intraoperative neuronavigation of glioma surgery

作　　者：韩志铁[1] 苏少波[1] 雪亮[1] 张川[1] 马俊[1] 王嘉拾[1] 岳树源[1] 

机构地区：[1]天津医科大学总医院神经外科,300052

出　　处：《中国现代神经疾病杂志》2013年第4期324-329,共6页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：天津市卫生局科技基金资助项目(项目编号:11KG136)~~

摘　　要：研究背景随着多模态影像融合技术在临床的应用,11C-Met PET与MRI融合技术也应用于临床,本研究通过比较胶质瘤在11C-Met PET与MRI中不同影像显示结果,探讨11C-Met PET与MRI影像融合技术在脑胶质瘤外科手术前评价、术中导航和手术切除过程中的应用价值。方法手术前于神经导航工作站对25例胶质瘤患者进行11C-Met PET与MRI影像融合,勾画肿瘤边界、计算肿瘤体积并进行分类。结果据影像学分类,25例胶质瘤患者中1例Ⅱ级、6例Ⅲ级和8例Ⅳ级MRI所显示的肿瘤灶轮廓大部分位于PET内(Ⅰ类);2例Ⅲ级PET所显示的肿瘤灶轮廓大部分位于MRI内(Ⅱ类);6例Ⅱ级和2例Ⅲ级MRI与PET显示的病灶轮廓无从属关系(Ⅲ类)。结论 PET在揭示胶质瘤增殖活性和描述肿瘤界限方面具有特殊优势,通过MRI与PET所显示的肿瘤轮廓关系,可用于术前初步预测肿瘤病理分级,有助于制定详细的手术计划。Background With the development of image fusion technology in clinical application, the fusion of ^11C-methionine （^11C-Met） PET and MRI is also used in clinic. Based on different image results in ^11C-Met PET and MRI of gliomas, this article aims to evaluate the application value of integration of MRI and ^11C-Met PET in preoperative assessment, intraoperative neuronavigation and tumor resection of glioma surgery. Methods Twenty-five patients with gliomas were examined with both MRI and ^11C-Met PET before operation. Based on the integrated ^11C- Met PET/MRI images, the neuronavigation workstation performed tumor delineation and calculated the tumor volume. Histological classification of tumors was performed according to WHO grades. The percentages of discrepancy-PET （vPET not included in vMRI） and discrepancy-MRI （vMRI not included in vPET） were evaluated on the fusion images. Results There were 3 ^11C- Met PET/MRI integration patterns emerged after analysis of volumetric data. One group included 15 cases （one was WHO ]/, six were WHO Ill and eight were WHO Ⅳ） with vMRI included in vPET with a low discrepancy-MRI. The second one included 2 patients with WHO Ⅲ gliomas with vPET included in vMRI with a low discrepancy-PET. The third group included 8 cases （six were WHO Ⅱand two were WHO Ⅲ） with vMRI-different-from-vPET. Conclusion ^11C-Met PET is able to accurately delineate tumor boundary and sensitively target the region of high proliferation or metabolism. Different ^11C- Met PET/MRI integration patterns can be assigned in tumor classfication and are favorable for making surgery plans.

关 键 词：正电子发射断层显像术 磁共振成像 神经胶质瘤 监测 手术中 

分 类 号：R739.4[医药卫生—肿瘤]