^18F—NaFPET／CT与MRI在鼻咽癌颅底骨质受侵中的对比研究  

Diagnostic value of ^18F-NaF PET/CT and MRI in detecting skull-base bone invasion of nasopharyngeal carcinoma

作　　者：乐亚丽 陈雨[2] 陈跃[1] 黄占文[1] 吴敬波[2] 赵冬梅[3] 张莉[1] 唐光才[3] 

机构地区：[1]泸州医学院附属医院核医学科,646000 [2]泸州医学院附属医院肿瘤科,646000 [3]泸州医学院附属医院放射科,646000

出　　处：《中华核医学与分子影像杂志》2016年第1期34-38,共5页Chinese Journal of Nuclear Medicine and Molecular Imaging

基　　金：四川省科学技术厅与泸州市人民政府、泸州医学院联合科研专项基金（14ZC0062）

摘　　要：目的探讨^18F—NaFPET／CT与MRI在鼻咽癌颅底骨质受侵中的诊断价值。方法前瞻性研究63例（男45例，女18例，年龄23—72岁）鼻咽癌（NPC）患者的^18F—NaFPET／CT和MRI检查资料。以6个月左右的影像随访结果为“最终判断标准”，计算^18F—NaFPET／CT与MRI诊断NPC颅底骨质受损的灵敏度、特异性、阳性预测值、阴性预测值及准确性，并行石。检验。另外比较2种影像学检查方法对最终确诊的NPC颅底骨质受侵患者的病灶检出及其分布情况。结果随访确诊为NPC颅底骨质受侵的患者有34例，^18F-NaFPET／CT检查真阳性33例，假阳性3例，真阴性26例，假阴性1例；MRI检查真阳性31例，假阳性4例，真阴性25例，假阴性3例；其中有30例患者在^18F-NaFPET／CT和MRI上均表现为颅底骨质受侵。^18F—NaFPET／CT诊断NPC颅底骨质受侵的灵敏度、特异性、阳性预测值、阴性预测值和准确性分别为97．1％（33／34）、89．7％（26／29）、91．7％（33／36）、96．3％（26／27）和93．7％（59／63），MRI的相应指标分别为91．2％（31／34）、86．2％（25／29）、88．6％（31／35）、89．3％（25／28）和88．9％（56／63）。2种影像学检查方法各诊断效能指标间差异均无统计学意义（x^2=0．162～1．062，均P〉0．05）。在34例NPC颅底骨质受侵患者中，^18F-NaFPET／CT检出颅底骨质病灶133个，MRI检出97个，斜坡是NPC颅底骨质受侵最好发的解剖位点。结论^18F—NaFPET／CT与MRI对NPC颅底骨质受侵具有相似的诊断效能，但^18F—NaFPET／CT检出的病灶总数多于MRI，提示前者在颅底微小骨质病灶的诊断上具有潜在优势。Objective To evaluate the value of ^18F-NaF PET/CT and MRI in the diagnosis of skull-base bone invasion （SBBI） in patients with nasopharyngeal carcinoma（NPC）. Methods Sixty-three NPC patients （45 males, 18 females; age range 23-72 years） were enrolled in this prospective study. Patients underwent ^18F-NaF PET/CT and MRI to confirm whether the skull base was invaded. The reference standard was based on the follow-up imaging in 6 months. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of the two imaging modalities were calculated. x^2 test was used to analyze their difference. The SBBI foci and their distribution detected by the two imaging modalities were compared. Results Thirty-four NPC patients demonstrated SBBI in follow-up imaging. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of lS F-NaF PET/CT were 97.1% （ 33/34）, 89.7% （26/29）, 91.7% （33/36）, 96.3% （26/27） and 93.7% （59/63）, respectively. For MRI, the parameters were 91.2%（31/34）, 86.2%（25/29）, 88.6%（31/35）, 89.3%（25/28） and 88.9% （56/63） , respectively. The diagnostic efficiency of the two imaging modalities had no significant difference （X2 = O. 162-1.062, all P〉0.05）. ^18F-NaF PET/CT detected 133 lesions and MRI detected 97 Resions, and the clivus was the most common site of SBBI. Conclusions ^18F-NaF PET/CT and MRI have similar diagnostic efficiency in detecting SBBI. ^18F-NaF PET/CT can detect more lesions than MRI do, and has potential advantage for detecting tiny bone lesions in skull base.

关 键 词：鼻咽肿瘤 骨骼 颅底 体层摄影术 发射型计算机 体层摄影术 x线计算机 氟化 钠:磁共振成像 

分 类 号：R739.63[医药卫生—肿瘤] R730.44[医药卫生—临床医学]