18氟-氟代脱氧葡萄糖正电子发射断层显像/磁共振成像与头颈部鳞癌病理分化的相关性及诊断价值  

Correlations of ^(18)F-Fluorodeoxyglucose Positron Emission Tomography/Magnetic Resonance Imaging Parameters with the Pathological Differentiation of Head and Neck Squamous Cell Carcinoma and Their Diagnostic Efficiencies

作　　者：党浩丹 陈钰[1] 师晓华[2] 侯波[1] 邢海群[3] 张韬[4] 陈兴明[5] 张竹花[1] 薛华丹[1] 金征宇[1] DANG Haodan;CHEN Yu;SHI Xiaohua;HOU Bo;XING Haiqun;ZHANG Tao;CHEN Xingming;ZHANG Zhuhua;XUE Huadan;JIN Zhengyu(Department of Radiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Pathology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Nuclear Medicine,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Stomatology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China;Department of Otolaryngology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China)

机构地区：[1]中国医学科学院,北京协和医学院,北京协和医院放射科,北京100730 [2]中国医学科学院,北京协和医学院,北京协和医院病理科,北京100730 [3]中国医学科学院,北京协和医学院,北京协和医院核医学科,北京100730 [4]中国医学科学院,北京协和医学院,北京协和医院口腔科,北京100730 [5]中国医学科学院,北京协和医学院,北京协和医院耳鼻喉科,北京100730

出　　处：《中国医学科学院学报》2018年第2期242-249,共8页Acta Academiae Medicinae Sinicae

基　　金：卫生公益性行业科研专项项目(201402019)和中央级公益性科研院所基本科研项目(2017PT32004)

摘　　要：目的探讨头颈部鳞癌(HNSCC)术前正电子发射断层显像/磁共振成像(PET/MR)各参数与病理分化程度的相关性,并评价PET及扩散加权成像(DWI)序列独立及联合诊断HNSCC病理分化程度的价值。方法选取2015年2月至2017年9月临床怀疑头颈部肿瘤的患者并进行PET/MR检查。PET/MR检查序列包括PET及T1加权成像、T2加权成像和DWI序列。所有最终入组患者均为术后病理诊断为HNSCC的病例。测量表观扩散系数平均值(ADC_(mean))、标准化摄取最大值(SUV_(max))及标准化摄取平均值(SUV_(mean)),比较PET/MR各参数在HNSCC高分化及中-低分化两组间的分布及其相关性。采用Logistic回归分析建立多参数对HNSCC分化程度的预测模型,根据受试者工作特征曲线计算PET/MR各参数独立及多参数联合应用诊断HNSCC病理分化程度的效能。结果最终纳入23例患者,均为男性;高分化9例,平均年龄(61.0±6.8)岁;中—低分化14例(10例中分化及4例低分化),平均年龄(62.0±9.1)岁。PET/MR参数中,SUV_(max)和SUV_(mean)具有强相关性(P<0.001),ADC_(mean)和SUV_(max)、SUV_(mean)无相关性(P=0.42,P=0.13)。ADC_(mean)和SUV_(mean)在HNSCC高分化组及中—低分化组间差异有统计学意义(P=0.005,P=0.007)。相较PET/MR各参数独立诊断,PET/MR多参数联合应用诊断HNSCC病理分化的曲线下面积为0.84。结论 ADC_(mean)、SUV_(max)和SUV_(mean)在HNSCC不同病理分化组间分布差异有统计学意义,相比较PET和MR的各参数独立预测病理分化程度,多参数联合应用可以更有效地提高HNSCC病理分化程度的预测效能。Objective To evaluate the correlation of the positron emission tomography/magnetic resonance imaging(PET/MR)parameters with the pathological differentiation of head and neck squamous cell carcinoma(HNSCC)and the diagnostic efficiencies of PET/MR parameters.Methods Patients with clinical suspicion of HNSCC were included and underwent PET/MR scan.HNSCC was pathologically confirmed in all these patients.The PET/MR examination included PET and MR sequences of diffusion-weighted imaging(DWI)and T2-and T1-weighted imaging.The multiple parameters of PET/MR included the mean values of apparent diffusion coefficient(ADC mean)and the maximum and mean values of standardized uptake value(SUV max and SUV mean)were measured and estimated.The correlations of all the parameters and distribution between the different tumor differentiation groups were analyzed.Logistic regression was utilized to build the model as the PET/MR combined parameter for predicting the differentiation by multiple parameters of PET/MR.The receiver operating characteristic curve was calculated for each parameter and the combination.Results Totally 23 patients were included in this study:9 patients(9 males and 0 female)had well-differentiated tumor,with an average age of(61.0±6.8)years;14 cases had moderately-differentiated(n=10)or poorly-differentiated tumors(n=4),with an average age of(62.0±9.1)years.All the patients were males.There was statistical correlation between SUV mean and SUV max(P<0.001);however,ADC mean showed no statistical correlation with SUV max and with SUV mean(P=0.42,P=0.13).ADC mean and SUV mean showed significant difference between well-differenti ated group and moderately-poorly-differentiated group(P=0.005,P=0.007).Compared with the individual parameters,the combination of PET/MR parameters with SUV mean and ADC mean had higher efficacy in predicting tumor differentiation,with an area under curve of 0.84.Conclusions The distributions of ADC mean,SUV max and SUV mean differ among HNSCC with different pathological differentiation.Co

关 键 词：正电子发射断层显像 磁共振成像 头颈部鳞状细胞癌 标准化摄取值 扩散加权成像 表观扩散系数 肿瘤病理分化 

分 类 号：R445.2[医药卫生—影像医学与核医学]