^(18)F-FDG PET显像对脑内多发性高级别胶质瘤与淋巴瘤的鉴别诊断  

Differential diagnosis of brain multifocal high-grade gliomas and lymphomas by ^(18)F-FDG PET imaging

作　　者：王凯[1] 吴桐[1] 陈谦[1] 艾林[1] WANG Kai;WU Tong;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：《中国临床医学影像杂志》2022年第8期577-581,共5页Journal of China Clinic Medical Imaging

基　　金：国家自然科学基金青年项目(82001769)。

摘　　要：目的:研究^(18)F-FDG PET显像对脑内多发性高级别胶质瘤和淋巴瘤的鉴别诊断价值。方法:回顾性收集我院2020年11月—2021年12月诊断为脑内多发性占位患者(24例)的临床信息和^(18)F-FDG PET图像资料。所有入组患者经病理诊断为脑内多发性高级别胶质瘤和淋巴瘤。在影像工作站上对24例患者脑内多发病灶进行参数测量,包括最大标准摄取值(Maximum standardized uptake value,SUVmax)、肿瘤-本底比值(Tumor background ratio,TBR)、最大SUVmax差值(D_(SUV))、最大SUVmax差值百分比(D_(SUV)%)、最大TBR差值(D_(TBR))和最大TBR差值百分比(D_(TBR)%)。通过ROC曲线分析各指标对脑内多发性高级别胶质瘤和淋巴瘤的鉴别诊断效能。结果:脑内多发性淋巴瘤病灶的最大SUVmax(21.70±10.12 vs 13.71±7.46,P=0.040)、最小SUVmax(15.17±7.83 vs 5.59±2.09,P=0.006)、最大TBR(7.03±3.25 vs 4.48±2.46,P=0.045)和最小TBR(4.92±2.64 vs 1.81±0.61,P=0.008)均高于多发性高级别胶质瘤病灶,二者之间差异具有统计学意义。ROC曲线分析结果认为D_(SUV)%和D_(TBR)%对鉴别脑内多发性高级别胶质瘤和淋巴瘤具有同等诊断效能,其AUC为0.944,诊断阈值为39.8%,敏感性为92.9%,特异性为88.9%,约登指数为0.818。结论:^(18)F-FDG PET脑显像中D_(SUV)%和D_(TBR)%对鉴别脑内多发性高级别胶质瘤和淋巴瘤具有一定临床应用价值。Objective:To study the value of^(18)F-FDG PET in the differential diagnosis of multiple high-grade gliomas and multiple lymphomas in the brain.Methods:The clinical information and^(18)F-FDG PET images of 24 patients with multiple brain lesions diagnosed in our hospital from November 2020 to December 2021 were collected retrospectively.All patients were pathologically diagnosed as multiple high-grade gliomas or lymphomas.The parameters of multiple lesions in the brain of24 patients were measured on the imaging workstation,including maximum standard uptake value(SUVmax),tumor background ratio(TBR),maximum SUVmax difference(D_(SUV)),maximum SUVmax difference percentage(D_(SUV)%),maximum TBR difference(D_(TBR))and maximum TBR difference percentage(D_(TBR)%).ROC curve was used to analyze the efficacy of each index in the differential diagnosis of multiple glioma and lymphoma in the brain.Results:The maximum SUVmax(21.70±10.12 vs 13.71±7.46,P=0.040),the minimum SUVmax(15.17±7.83 vs 5.59±2.09,P=0.006),the maximum TBR(7.03±3.25 vs 4.48±2.46,P=0.045) and the minimum TBR(4.92±2.64 vs 1.81±0.61,P=0.008) of intracerebral multiple lymphoma were significantly higher than those of multiple glioma.The ROC curve analysis showed that D_(SUV)% and D_(TBR)% had the same diagnostic efficiency in differentiating multiple high-grade gliomas and lymphoma in the brain.The AUC was 0.944,the diagnostic threshold was 39.8%,the sensitivity was 92.9%,the specificity was 88.9%,and the Yoden index was 0.818.Conclusion:D_(SUV)% and D_(TBR)% in^(18)F-FDG PET brain imaging have certain clinical value in differentiating multiple gliomas and multiple lymphomas in the brain.

关 键 词：脑肿瘤 神经胶质瘤 淋巴瘤 正电子发射断层显像计算机体层摄影术 氟脱氧葡萄糖F18 

分 类 号：R739.41[医药卫生—肿瘤] R817.4[医药卫生—临床医学] R445.2