^(99m)Tc-MIBI SPECT与^(18)F-FDG PET诊断胶质瘤复发及恶变对比分析

Comparison of ^(99m)Tc-sestamibi SPECT and ^(18)F-FDG PET imaging in the diagnosis of recurrence and malignancy of glioma

对28例经过治疗的胶质瘤患者进行Gd－DTPAMRI和18F－FDGPET显像，其中14例同时进行99mTc－MIBISPECT显像，并与治疗前解剖影像对比。PET结果发现14例高代谢，10例低代谢，4例瘤灶中心坏死，周边FDG环状摄取。8例首次手术病理Ⅰ－Ⅱ级星形细胞瘤患者中5例为高代谢。18F-FDGPET和99mTc－MIBISPECT诊断胶质瘤复发及恶变的灵敏度依次为93．3％、91．7％。准确性依次为94．1％、85．7％．PET比MRI增强扫描及MIBISPECT显像更能准确鉴别胶质瘤的复发与恶变，MIBISPECT检出的病变范围比PET大。

This study compares the diagnostic value of 18F-FDG PET and 99mTc-MIBISPECT imaging in the diagnosis of recurrence and malignancy of glioma. 28 patientswith glioma post treatment were performed by MRI or/and CT and 18F-FDG PETimagmg, and 14 of them were also performed by 99mTc-MIBI SPECT. On PET scans,10 patients were hypometabolic, 4 patients were central non-metabolic withperipheral rm FDG uptake, 14 patients were hypermetabolic. Out of 8 patients withastrocytoma Ⅰ - Ⅱ grade confirmed by operation, 5 ones showed hypermetabolic,indicating malignant degeneration of low-grade glioma. The sensitivity and accuracyof 18F-FDG PET and 99mTc-MIBI SPECT in the diagnosis of recurrence andmalignant degeneration of glioma were 93.3%, 94.1% and 91.7%, 85.7% respectively.FDG PET imaging is the most accurate method in the detection of recurrence andmalignant degeneration of low-grade glioma, compared with MRI enhancement and99mTc-MIBI SPECT. The extent of lesion site detected by MIBI scans is usuallybigger than FDG PET imaging.