18F-FDG PET/CT与MRI异机融合在高级别脑胶质瘤鉴别诊断中的价值

Diagnostic Value of 18F-FDG PET/CT Combined with MRI in High-grade Glioma

目的 探讨18F-FDG PET/CT与MRI异机融合在高级别脑胶质瘤(HGG)诊断中的价值。方法 回顾性分析90例经组织病理学证实的高级别脑胶质瘤(HGG)(n=31)、原发性中枢神经系统淋巴瘤(PCNSL)(n=20)和脑转移瘤(BM)(n=39)患者。所有患者同一天先后接受18F-FDG PET/CT和MRI双倍剂量增强扫描。采用视觉分析3组患者的病灶分布和形态特征,以及半定量参数最大标准化摄取值(SUVmax)、标准化摄取值均值(SUVmean)、肿瘤与对侧相应部位正常脑组织SUVmax的比值(T/N),采用Mann-Whitney U检验和多因素回归分析及受试者工作特征(ROC)曲线分析两两组间关系。评价异机融合18F-FDG PETCT/MRI在HGG鉴别诊断中的价值。结果 增强特征、占位效应和病灶部位在HGG、PCNSL和BM组间差异具有统计学意义(P<0.05);半定量分析中,PCNSL的SUVmax、SUVmean和T/N值均显著高于HGG(P<0.05)和BM(P<0.05)。ROC曲线分析显示,强化特征和SUVmean在区分HGG和PCNSL方面具有良好的诊断效能(AUC=0.927);SUVmax和强化特征可以作为PCNSL和BM组间良好的分类预测模型(AUC=0.918)。结论18F-FDG PET/CT代谢参数联合MR双倍剂量增强形态学特征在诊断和鉴别颅内HGG中具有重要的价值和意义。

Objective To investigate the value of 18F-FDG PET/CT combined with MRI in the diagnosis of high-grade glioma(HGG).Methods A retrospective analysis of 90 patients with histopathologically confirmed high-grade glioma(HGG)(n=31),primary central nervous system lymphoma(PCNSL)(n=20)and brain metastases(BM)(n=39).All patients underwent 18F-FDG PET/CT and MRI double-dose enhancement scans on the same day.Visual analysis of the distribution and morphological characteristics of the lesions in the three groups,as well as the semi-quantitative parameters maximum standardized uptake value(SUVmax),mean standardized uptake value(SUVmean),and the ratio of tumor to SUVmax in the corresponding contralateral part of the brain tissue(T/N),was performed using the Mann-Whitney U test and multifactorial regression analysis and subject work characteristics(ROC)curves to analyze the relationship between the two groups.To evaluate the value of hetero-organic fusion 18F-FDG PET-CT/MRI in the differential diagnosis of HGG.Results In qualitative analysis,enhancing features,occupancy effect and lesion location were statistically significant between the groups of high-grade glioma,primary central nervous system lymphoma and brain metastases(P<0.05);in semi-quantitative analysis,SUVmax,SUVmean and T/N values were significantly higher in PCNSL than in HGG(P<0.05)and BM(P<0.05).ROC curves showed that reinforcing features and SUVmean had good diagnostic efficacy in distinguishing HGG from PCNSL(AUC=0.927);SUVmax and reinforcing features could be used as good classification prediction models between PCNSL and BM groups(AUC=0.918).Conclusion The value and significance of 18F-FDG PET/CT metabolic parameters combined with MR double-dose enhancement morphological features in the diagnosis and differentiation of intracranial HGG.