PET/CT与MR多模式分子影像技术对盆腔肿瘤的诊断价值

PET/CT-MR multimodality molecular imaging in the pelvic tumor diagnosis

目的评估PET/CT与MR多模式分子影像技术对盆腔肿瘤的诊断价值,并对高b值反映水通道蛋白信息的水分子扩散成像技术临床价值进行研究。方法选择10例临床诊断明确的盆腔肿瘤患者,先进行18F-FDG PET/CT全身扫描,然后用专用的患者转运床将患者移到MR进行常规序列和多b值扫描。分别在工作站获得18F-FDG PET/CT融合图与不同b值DWI所对应水分子扩散成像表观扩散系数(ADC)图。分别统计PET/CT、MRI + DWI、MRI + AQP及PET/CT结合MRI + AQP发现肿瘤的数量,用t检验进行统计学分析。结果 b值大于1500 s/mm2时盆腔膀胱、肠道等自由扩散水分子信号消失,盆腔肿瘤可以清晰显示。18F-FDG PET/CT与MRI + AQP发现肿瘤数量与临床诊断间差异无统计学意义(t= 1.50, P= 0.17;t= -1.0, P= 0.34),而MRI + DWI方法发现的病灶数多于临床诊断(t = 2.45, P = 0.04)。18F-FDG PET/CT结合MRI与AQP MR结果与临床诊断结果一致。结论 18F-FDG PET/CT结合MR及其高b值图像能够提高对盆腔肿瘤的检出率。这对于肿瘤早期诊断、准确分期和指导个体化治疗具有重要的价值。

Objective To evaluate the performance of PET/CT-MR multimodality molecular imaging in pelvic tumor diagnosis, and to investigate thevalue of high b-value DWI, which reflect the aquaporin （AQP）, in clinical applications. Methods 10 subjects, all with confirmed pelvic tumors, was recruited. ^18F-FDG PET/CT whole body scan and multi-b value DWI scans were performed. Special patient transport bed was used to move the subjects between scans. Respectively in the workstation get of ^18F-FDG PET/CT integrated image and the apparent diffusion coefficient （ADC） maps of different b value. Respectively count the numbers of tumor on the images of PET/CT, MRI ＋ DWI, MRI ＋ AQP and PET/CT combined with MRI ＋ AQP. The dates were analysed with t test. Results The bladder, bowel and pelvic cavity when b is greater than 1500 s/mm^2 free diffusion of water molecules signal disappears, pelvic tumors can be clearly showed. The differences between numbers of tumor on the PET/CT and MRI ＋ DWI with clinic diagnosed were not significant （t = 1.50, P = 0.17; t = -1.0, P = 0.34）. The number on MRI ＋ DWI was more than clinic diagnosed （t = 2.45, P = 0.04）. The result of PET/CT combined with MRI ＋ AQP was in accordance with clinic diagnosed. Conclusion ^18F-FDG PET/CT in combination with MR high b value image can improve the efficiency of pelvic tumor diagnosis. This for tumor early diagnosis, accurate staging and guide individualized treatment is of great value.