(18)^F-FDG PET/MR成像对脑内肿瘤样脱髓鞘病的诊断价值  

The diagnostic value of (18)^F-FDG PET/MR for cerebral tumefactive demyelinating lesions

作　　者：王凯[1] 张姝[1] 乔真[1] 吴桐[1] 樊迪 陈谦[1] 艾林[1] WANG Kai;ZHANG Shu;QIAO Zhen;WU Tong;FAN Di;CHEN Qian;AI Lin(Department of Nuclear Medicine,Beijing Tiantan Hospital,Capital Medical University,Beijing 100070,China)

机构地区：[1]首都医科大学附属北京天坛医院核医学科,北京100070

出　　处：《磁共振成像》2022年第4期20-25,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金(编号:82001769)。

摘　　要：目的研究;F-氟代脱氧葡萄糖(fluorodeoxyglucose,FDG)正电子发射断层成像(positron emission tomography,PET)/MR多模态成像对肿瘤样脱髓鞘病(tumefactive demyelinating lesions,TDL)的诊断价值。材料与方法回顾性分析我院2019年11月至2021年11月间可疑诊断TDL患者病例共39例,包括患者临床信息和多模态PET/MR图像。在影像工作站上通过勾画病灶感兴趣区测量所有39例病灶的影像学参数,包括标准摄取值(standard uptake value,SUV)、病灶代谢体积、糖酵解总量、脑血流量、脑血容量、表观扩散系数(apparent diffusion coefficients,ADC)。通过受试者工作特征(receiver operating characteristic,ROC)曲线计算每种影像指标的诊断效能,其次采用Logistic单因素及多因素分析筛选出具有诊断价值的影像指标,将这些指标联合起来计算其综合诊断效能。结果TDL组SUV_(max)和SUV_(mean)均显著高于非TDL组(13.65±2.31vs.10.03±1.96,P=0.028;8.30±0.58 vs.6.25±1.53,P=0.023)。TDL组的ADC;高于非TDL组(1.10±0.13 vs.0.86±0.51),二者间差异具有统计学意义(P=0.013)。ROC分析显示SUV_(max)、SUV_(mean)和ADC_(mean)的ROC曲线下面积(area under curve,AUC)分别为[0.920,95%置信区间(confidence interval,CI):0.738~1.102;0.940,95%CI:0.791~1.089;0.960,95%CI:0.843~1.077,P值均<0.001]。联合指标(SUV;+SUV;+ADC;)的AUC为0.973,95%CI:0.886~1.023(P<0.001)。结论(18)^F-FDG PET/MR多模态成像对临床TDL诊断及鉴别诊断具有一定价值。Objective:To investigate the diagnostic value of;F-fluorodeoxyglucose(FDG)positron emission tomography(PET)/MR multimodal imaging in tumefactive demyelinating diseases(TDL).Materials and Methods:A total of 39 patients with suspected TDL from November 2019 to November 2021 were collected retrospectively,including their clinical information and multimodal PET/MR images.The imaging parameters of all 39 patients were measured by drawing the region of interest on the imaging workstation,including standard uptake value(SUV),lesion metabolic volume,total glycolysis,cerebral blood flow,cerebral blood volume,and ADC.The diagnostic efficacy of each image index was calculated by receiver operating characteristic(ROC)curve;moreover,the image indexes significantly associated with diagnostic performance were screened by univariant and multivariant logistic analysis,and then,these indexes were combined to generate the integrated diagnostic efficacy.Results:SUVmaxand SUVmeanin TDL group were significantly higher than those in non-TDL group(13.65±2.31 vs.10.03±1.96,P=0.028;8.30±0.58 vs.6.25±1.53,P=0.023).ACDmeanin TDL group was higher than that in non-TDL group(1.10±0.13 vs.0.86±0.51),and the difference was statistically significant(P=0.013).ROC analysis showed that the area under curve(AUC)of SUV_(max),SUVmeanand ADC_(mean)were[0.920,95%confidence interval(CI):0.738-1.102;0.940,95%CI:0.791-1.089;0.960,95%CI:0.843-1.077,respectively,P<0.001].The AUC of the integrated diagnostic index(SUV_(max)+SUV_(mean)+ADC_(mean))was 0.973,and the 95%CI:0.886-1.023(P<0.001).Conclusions:(18)^F-FDG PET/MR multimodal imaging has a degree of value in clinical diagnosis and differential diagnosis of TDL.

关 键 词：肿瘤样脱髓鞘病 氟代脱氧葡萄糖 正电子发射断层成像 磁共振成像 脑肿瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R744.5[医药卫生—诊断学]