增强MRI和^(18)F-FDG PET-CT对胶质瘤术后复发病灶诊断价值的比较  

Comparison of diagnostic values between enhanced MRI and ^(18)F-FDG PET/CT in recurrence lesions of glioma

作　　者：何志明[1,2] 谢雪梅[3] 张紫寅[4] 王宏[1,2] 唐建建[4] 杨堃[4] 

机构地区：[1]四川省绵阳市四○四医院医学影像科 [2]川北医学院附属第二医院,四川绵阳621000 [3]中国医科大学第一附属医院病理科,沈阳110001 [4]海南医学院附属医院神经外科,海口570102

出　　处：《检验医学与临床》2014年第1期3-5,共3页Laboratory Medicine and Clinic

基　　金：国家"十一五"重大科技专项(2009zx1004-905)

摘　　要：目的比较并探讨增强MRI和18F-脱氧葡萄糖-正电子发射断层扫描(18F-FDG PET-CT)对胶质瘤术后复发病灶诊断结果。方法选取2002年5月至2011年5月已经病理学证实,并在以后治疗和随访过程中怀疑复发的胶质瘤患者94例。手术切除后结合化疗的为53例,切除后结合放疗和化疗的为35例,只是手术治疗或只是放疗的为6例。对怀疑复发的所有病例均行增强MRI和18 F-FDG PET-CT影像学检查。统计学比较采用McNemar检验。结果 MRI真阳性结果为53例(Ⅳ级8例,Ⅲ级25例,Ⅱ级17例,Ⅰ级3例),假阴性为7例(Ⅳ级1例,Ⅲ级1例,Ⅱ级1例,Ⅰ级4例);18F-FDG PET-CT真阳性结果为29例(Ⅳ级2例,Ⅲ级14例,Ⅱ级10例,Ⅰ级3例),假阴性为14例(Ⅳ级3例,Ⅲ级2例,Ⅱ级5例,Ⅰ级4例)。MRI对脑胶质瘤复发检出的敏感度较高为93.55%,特异度18.75%。而18F-FDG PET-CT的特异度67.44%和敏感度92.16%。通过总体和不同分级之间的比较,增强MRI与18F-FDG PET-CT一致的共有43例,结果不一致的有51例。统计结果表明,两者差异有统计学意义(χ2=8.50,P=0.013)。结论 18F-FDG PET-CT的敏感度较低,不建议作为检查复发的初级筛选手段。但可以在经过MRI检查出病灶后,再通过18F-FDG PET-CT进行一定特性描述的检查。Objective To compare and investigate the diagnostic value of the enhanced MRI and 18F-FDG PET in recurrence lesions of lioma. Methods 94 cases of glioma confirmed by the pathology and suspected recurrrence during subsequent treatment and follow up period from May 2002 to May 2011 were selected as the study subjects. 53 cases were performed the surgical excision combined with chemotherapy, 35 cases were treated by surgical excision combined with radiotherapy and chemotherapy and 6 cases were treated only by surgical excision or radiotherapy. All cases of suspected recurrence underwent both preoperative enhanced MRI and 18 F-FDG PET imaging. The statistical comparison was conducted by the McNemar test. Results The true positive results of MRI were 53 cases（8 cases of the grade IV,25 cases of the grade Ⅲ ,17 cases of the gradeH ,3 cases of the grade Ⅰ ） ;the false negative results were 7 cases（1 case of the grade IV ,1 case of the grade Ⅲ,1 case of the grade Ⅱ ,4 case of the grade Ⅰ ） ;the true positive results of JSF FDG PET were 29 cases（2 cases of the grade Ⅳ ,14 cases of the grade Ⅲ ,10 cases of the grade n ,3 ca- ses of the grade Ⅰ ） ;the false negative results were 14 cases（3 cases of the grade Ⅳ ,2 cases of the grade Ⅲ ,5 cases of the grade Ⅱ ,4 case of the grade Ⅰ ）. The sensitivity of MRI in detecting brain glioma recurrence was 93.55% ,but the specificity was 18.75%. And the specificity of 18F-FDG PET was 67.44% and its sensitivity was 92.16%. Through the overall and the comparison among different grades, the consistent results of MRI and 18 F-FDG PET had 43 cases, while the inconsistent results had 51cases, the results revealed that the difference between enhanced MRI and 18F FDG PET/CT had statistical significance（X^2 = 8. 50, P = 0. 013）. Conclusion The sensitivity of 18F-FDG PET is lower, it was not recommended as primary screening method for detecting recurrence. But after detecting lesions by MRI,the characterization examination could be performed by 18 F-F

关 键 词：胶质瘤 增强MRI 18F-脱氧葡萄糖-正电子发射断层扫描 复发 

分 类 号：R471[医药卫生—护理学]