16例颅内胶质瘤术后并放射治疗后的18F-FDG PET显像

^(18) F-FDG PET imaging of postoperative and postradiotherapeutic intracranial glioma compared with CT, MRI in 16 cases

目的 探讨18F 脱氧葡萄糖 (FDG)PET在颅内胶质瘤术后并放射治疗后随诊中的临床价值。方法 对 16例颅内胶质瘤术后并放射治疗后的患者同期行18F FDGPET和CT、MRI检查 ,采用双盲法对结果进行比较。结果 16例中 87 5 % (14例 )CT和 (或 )MRI表现不规则环形或结节状明显强化 ,不能准确作出手术后改变和 (或 )放射治疗后脑损伤、残存肿瘤或肿瘤复发的诊断 ;其中 9例残存肿瘤或肿瘤复发病灶18F FDGPET影像表现为葡萄糖代谢明显增高 ,有 5例得到手术病理证实 ;另 5例术后放射治疗后脑损伤患者和 2例术后软化灶18F FDGPET影像均显示局部病变区为放射性分布缺损或明显低下。结论 18F FDGPET在胶质瘤术后放射治疗后的脑损伤和肿瘤复发的定性诊断上具有明显的优势 ,结合CT和MRI更能提供病变解剖结构和功能改变的综合信息。

Objective To discuss the clinical value of 18 F FDG PET imaging in postoperative and postradiotherapeutic intracranial glioma during follow up study. Methods 18 F FDG PET imaging in 16 cases of postoperative and postradiotherapeutic intracranial glioma was compared with CT and/or MRI. Results Contrast CT or MRI showed prominent irregular circular or nodular enhancement in 14 of 16 cases (64%),can not distinguished from postopertative changes, radioinjury, tumor residue or recurrence.Among them, 9 cases showed tumor residue or recurrence based on significantly increased FDG uptake, 5 were confirmed by pathologic study. The other 5 cases of cerebral necrosis and 2 cases with postoperative cerebral malacia demonstrated FDG uptake defects. Conclusions 18 F FDG PET imaging has significant dominance in characterizing lesions for differentiating residue or recurrent disease from radioinjury in intracranial glioma. Combined with CT and MRI can provide both anatomical and functional informations.