PET/CT、头部增强CT和头部增强MRI对肺癌脑转移瘤检出价值的对比  

Comparation on the value of PET/CT,head-enhanced CT and head-enhanced MRI in the detection of brain metastases from lung cancer

作　　者：夏露花[1] 崇乐 马荣辉[3] 董占飞[1] 常诚 夏欢[1] 郭浩 彭岩[1] 王新华[1] XIA Luhua;CHONG Le;MA Ronghui;DONG Zhanfei;CHANG Cheng;XIA Huan;GUO Hao;PENG Yan;WANG Xinhua(Department of Nuclear Medicine,Tumor Hospital Affiliated to Xinjiang Medical University,Urumqi 830011,China;Department of Ultrasound Medicine,Tumor Hospital Affiliated to Xinjiang Medical University,Urumqi 830011,China;Department of Respiratory Neurology,Tumor Hospital Affiliated to Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学附属肿瘤医院核医学科,新疆乌鲁木齐830011 [2]新疆医科大学附属肿瘤医院超声科,新疆乌鲁木齐830011 [3]新疆医科大学附属肿瘤医院呼吸神经内科,新疆乌鲁木齐830011

出　　处：《分子影像学杂志》2022年第1期13-17,共5页Journal of Molecular Imaging

基　　金：新疆维吾尔自治区自然科学基金(2017D01C411)。

摘　　要：目的分析与探讨^(18)F-FDG PET/CT+头部增强CT、^(18)F-FDG PET/CT+头部增强MRI几种检查方法对肺癌脑转移瘤的诊断价值与差异。方法回顾分析327例肺癌患者的临床资料,对比其^(18)F-FDG PET/CT、头部增强CT及头部增强MRI影像资料,分析^(18)F-FDG PET/CT联合头部增强CT、^(18)F-FDG PET/CT联合头部增强MRI对肺癌分期的影响;比较^(18)F-FDG PET/CT、头部增强CT、头部增强MRI 3种检查方法对肺癌脑转移瘤检出价值;比较^(18)F-FDG PET/CT与头部增强MRI,肺癌脑转移瘤漏诊组与未漏诊组囊变、水肿表现的差异。结果^(18)F-FDG PET/CT+头部增强CT、^(18)F-FDG PET/CT+头部增强MRI这两种组合检查方法在检出肺癌脑转移瘤方面,对肺癌分期的影响差异有统计学意义(χ^(2)=305.58,P<0.01);^(18)F-FDG PET/CT、头部增强CT、头部增强MRI三种检查方法对肺癌脑转移瘤检出率分别为7.34%、12.23%、19.88%;3种检查方法对肺癌脑转移瘤检出情况比较差异具有统计学意义(χ^(2)=22.867,P<0.01);肺癌脑转移瘤^(18)F-FDG PET/CT与MRI比较漏诊组与未漏诊组发生囊变、水肿情况的差异无统计学意义(χ^(2)=0.657,P>0.05;χ^(2)=0.023,P>0.05);漏诊组、未漏诊组出现囊变率为31.70%(13/41)、41.67%(10/24);漏诊组、未漏诊组出现水肿率为56.09%(23/41)、54.17%(13/24)。结论^(18)F-FDG PET/CT+头部增强CT、^(18)F-FDG PET/CT+头部增强MRI检查均能够提高肺癌脑转移瘤的检出率,对精确判断肺癌分期,掌握脑转移瘤详细情况,降低脑转移瘤的漏诊率有重要作用,检出价值最高的是^(18)F-FDG PET/CT+头部增强MRI联合。Objective To analyze and discuss the diagnostic value and differences of ^(18)F-FDG PET/CT+head enhanced CT and ^(18)F-FDG PET/CT+head enhanced MRI for brain metastasis of lung cancer.Methods Clinical data of 327 patients with lung cancer were randomly selected to compare the imaging data of ^(18)F-FDG PET/CT,head-enhanced CT and head-enhanced MRI to analyze the effects of ^(18)F-FDG PET/CT combined with head enhanced CT and ^(18)F-FDG PET/CT combined with head-enhanced MRI on the staging of lung cancer.Comparison of the value of ^(18)F-FDG PET/CT,head-enhanced CT and head-enhanced MRI in the detection of brain metastases from lung cancer;Comparison between ^(18)F-FDG PET/CT with head-enhanced MRI,and the difference in the presentation of cystic lesions and oedema between the group with and without missed brain metastases from lung cancer.Results The combined examination methods of ^(18)F-FDG PET/CT+head enhanced CT and ^(18)F-FDG PET/CT+head enhanced MRI had a statistically significant difference in the detection of lung cancer brain metastasis(χ^(2)=305.58,P<0.01).The detection rates of brain metastases from lung cancer by PET/CT,head enhanced CT and head enhanced MRI were 7.34%,12.23%and 19.88%,respectively.The difference in the detection of brain metastases from lung cancer among the three methods was significant(χ^(2)=22.867,P<0.01).There was no significant difference in cystic degeneration and edema between the missed group and the unmissed group(χ^(2)=0.657,P>0.05;χ^(2)=0.023,P>0.05).The rate of cystic degeneration was 31.70%(13/41)in the missed diagnosis group and 41.67%(10/24)in the unmissed diagnosis group,and the rates of edema was 56.09%(23/41)in the missed diagnosis group and 54.17%(13/24)in the unmissed diagnosis group.Conclusion Both ^(18)F-FDG PET/CT+head enhanced CT and ^(18)F-FDG PET/CT+head enhanced MRI can improve the detection rate of lung cancer brain metastasis,which is important for accurately determining the stage of lung cancer,grasping the details of brain metastasis,and reducing th

关 键 词：肺癌 脑转移瘤 ^(18)F-FDG PET/CT 增强CT 增强MRI 

分 类 号：R734.2[医药卫生—肿瘤] R445.2[医药卫生—临床医学] R730.44