脑转移瘤18F-FDG PET/CT和MRI的表现特点及诊断价值比较  

Imaging features and comparision of diagnosis value of 18F-FDG PET/CT and MRI in patients with brain metastases

作　　者：程楠[1] 王振光[1] 李大成[1] 武凤玉[1] 刘思敏[1] 卢璐祥 陈成成[1] 

机构地区：[1]青岛大学医学院附属医院PET/CT中心,山东青岛266100

出　　处：《实用放射学杂志》2014年第3期382-386,共5页Journal of Practical Radiology

摘　　要：目的 探讨脑转移瘤18F-FDG PET/CT和MRI的表现特点并比较其诊断价值。方法 回顾性分析经临床或手术病理证实的32例脑转移瘤患者，所有患者均行全身18F-FDG PET/CT检查和MRI扫描或（和）MRI增强扫描，PET图像上将病灶摄取18F-FDG程度分为4级。分别由2位资深的核医学医师和影像学医师双盲法阅片。结果 32例脑转移瘤患者共确诊63个转移病灶，PET/CT检查诊断为脑转移瘤29例，共发现病灶48个，诊断准确率76.2%；MRI扫描诊断为脑转移瘤30例，共发现病灶数59个，诊断准确率93.7%。18F-FDG放射性摄取程度0级、1级、2级、3级分别占35.4%、14.6%、8.3%、41.7%。MRI检查中有78.0%（46/59）的病灶呈稍长或等长T1，长T2信号改变。结论 18F-FDG PET/CT和MRI诊断脑转移瘤各有优势及不足，要综合分析各表现特点，以提高对脑转移瘤的认识并准确诊断。Objective To discuss the imaging features of I8F-FDG PET/CT and MRI in patients with brain metastases,and compare their diagnosis value. Methods 32 histopathologieally proven brain metastases patients were analysed retrospectively. All patients underwent 18 F-FDG PET/CT and MRI or（and） enhanced MRI. The uptake of ^18F-FDG in the lesions of PET images were clas- sifted into 4 grades according to uptake degrees. All images were evaluated independently by two experienced nuclear medicine and imageology psysieians. They were blinded to the clinical and structrual imaging findings. Results A total of 63 metastase lesions were confirmed in 32 brain metastases patients ,PET/CT detected 29 cases （48 lesions ）,with the accuracy rating of 76.2G;MRI detected 30 cases （59 lesions） ,with the accuracy rating of 93.7%. The radioactive uptake of ^18F FDG in grade 0,grade 1 ,grade 2, grade 3 accounts for 35.4 %,14.6 %, 8.3%, 41.7%, separately. 78.0% （ 46/59 ） lesions expressed slightly or iso-long and high intensi ty on MR T1WI and T2WI. Conclusion ^18F-FDG PET/CT and MRI have their own advantages and shortages, we should analyse their imaging features comprehensively,in order to improve the cognition of brain metastases and diagnose exactly.

关 键 词：脑转移瘤 计算机体层成像 18F-脱氧葡萄糖 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤] R814.42[医药卫生—临床医学]