18F-FDG PET/CT漏诊脑转移瘤的MRI表现分析  

MRI performance analysis of 18F-FDG PET/CT missed diagnosis of brain metastases

作　　者：阮磊 靳水 夏亮[3] 庞伟强[2] 杨建涛 俞炎平[1] 孙才兴[3] 林静辉 邵国良[1] RUANLei;JIN Shui;XIA Liang;PANG Weiqiang;YANG Jiantao;YU Yanping;SUN Caixing;LIN Jinghui;SHAO Guoliang(Department of Radiology,Zhejiang Cancer Hospital,Hangzhou310022,China;Department of Nuclear Medicine,Zhejiang Cancer Hospital,Hangzhou310022,China;Department of Nuclear Neurosurgery,Zhejiang Cancer Hospital,Hangzhou310022,China;Department of Neurosurgery,Ningbo Fenghua District People's Hospital,Ningbo 315500,China)

机构地区：[1]浙江省肿瘤医院放射科,浙江杭州310022 [2]浙江省肿瘤医院核医学科,浙江杭州310022 [3]浙江省肿瘤医院神经外科,浙江杭州310022 [4]宁波市奉化区人民医院神经外科,浙江宁波315500

出　　处：《中国现代医生》2020年第4期129-132,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2019RC127);国家自然科学基金项目(81502147);浙江省中医药重点研究项目(2016ZA039);浙江省医药卫生科技计划项目(2017KY260)。

摘　　要：目的探讨18F-FDG PET/CT漏诊脑转移瘤的MRI表现特点。方法回顾性分析2017年1月~2018年11月经临床或治疗证实的脑转移瘤患者共17例的18F-FDG PET/CT和MRI资料,对比分析18F-FDG PET/CT漏诊组和未漏诊组脑转移瘤的MRI表现特点。结果17例患者MRI共诊断43个病灶,18F-FDG PET/CT漏诊6例共12个病灶,漏诊率27.9%(12/43)。漏诊病灶均呈稍长或长T2、长T1信号,11个(11/12)病灶环形强化、1个均匀强化;漏诊组病灶T2WI最大径(中位数1.45 cm)明显小于未漏诊组(中位数2.20 cm),差异有统计学意义(P<0.05);漏诊组病灶的MRI强化范围(中位数0.65 cm)明显小于未漏诊组(中位数1.40 cm),差异有统计学意义(P<0.05);漏诊组与未漏诊组病灶有水肿个数占比分别为58.3%(7/12)和54.8%(17/31),差异无统计学意义(P>0.05);漏诊组病灶与未漏诊组病灶有囊变个数占比分别为33.3%(4/12)和45.2%(14/31),差异无统计学意义(P>0.05)。结论18F-FDG PET/CT漏诊脑转移瘤与未漏诊者MRI表现有一定的差异。Objective To investigate the MRI performance features of 18F-FDG PET/CT missed diagnosis of brain metastases.Methods 18F-FDG PET/CT and MRI data of 17 cases of clinically or therapeutically confirmed brain metastases from January 2017 to November 2018 were retrospectively analyzed.The MRI features of 18F-FDG PET/CT missed diagnosis metastases group and unmissed diagnosis metastases group were compared and analyzed.Results A total of 43 lesions were diagnosed by MRI in 17 patients.There were 12 lesions in 6 cases of 18F-FDG PET/CT missed diagnosis.The rate of missed diagnosis was 27.9%(12/43).The missed lesions showed slightly longer or longer T2 and longer T1 signals,11(11/12)ring-enhanced lesions and 1 uniform enhancement.The T2WI maximum diameter(median 1.45 cm)of lesions in the missed diagnosis group was significantly smaller than that of the undiagnosed group(median 1.45 cm),and the difference was statistically significant(P<0.05).The MRI enhancement range(median 0.65 cm)of the missed diagnosis group was significantly smaller than that of the unmissed diagnosis group(median 1.40 cm),and the difference was statistically significant(P<0.05).The proportion of edema in the missed and unmissed diagnosis group was 58.3%(7/12)and 54.8%(17/31),respectively,and the difference was not statistically significant(P>0.05).The proportion of cystic changes in the missed and unmissed diagnosis group was 33.3%(4/12)and 45.2%(14/31),respectively,and the difference was not statistically significant(P>0.05).Conclusion There is a certain difference in MRI findings between patients with18F-FDG PET/CT missed diagnosis brain metastases and those with 18F-FDG PET/CT unmissed diagnosis brain metastases.

关 键 词：脑转移瘤 18F-FDG PET/CT 磁共振成像 漏诊 

分 类 号：R739.4[医药卫生—肿瘤]