摘要
目的探讨正电子发射计算机断层成像(PET/CT)及MRI弥散张量成像对脑胶质瘤复发与放射性脑损伤的鉴别诊断价值。方法选取2015年6月至2018年6月间中国人民武装警察部队海警总队医院收治的145例脑胶质瘤手术后放疗患者,所有患者放疗3~6个月后行PET/CT及MRI弥散张量成像复查。比较患者的临床资料、PET/CT指标及MRI弥散张量成像指标,通过绘制受试者工作特征(ROC)曲线分析各指标鉴别诊断脑胶质瘤复发与放射性脑损伤的价值。结果脑胶质瘤复发患者标准摄取值(SUV)、病灶正常组织比(L/N)、局部脑血容量(rCBV)、局部脑血流量(rCBF)、胆碱/肌酸比值(Cho/Cr)及Cho/N-乙酰天门冬氨酸比值(Cho/NAA)均高于放射性脑损伤,差异均有统计学意义(均P<0.05);SUV、L/N、rCBV、rCBF、Cho/Cr及Cho/NAA鉴别脑胶质瘤复发与放射性脑损伤的ROC曲线下面积(AUC)分别为0.874、0.828、0.952、0.928、0.853及0.905;rCBV鉴别脑胶质瘤复发与放射性脑损伤的AUC高于L/N和Cho/Cr,差异有统计学意义(P<0.05);rCBV鉴别脑胶质瘤复发与放射性脑损伤最佳截点为1.458,敏感度和特异度分别为90.8%和94.1%。结论脑胶质瘤复发患者SUV、L/N、rCBV、rCBF、Cho/Cr及Cho/NAA等指标明显升高,高于放射性脑损伤患者,MRI弥散张量成像指标鉴别脑胶质瘤复发与放射性脑损伤优于PET/CT,尤其是rCBV指标,更具临床价值。
Objective To explore the significance of positron emission tomography-computed tomography(PET/CT)versus diffusion tensor magnetic resonance imaging(MRI)in the differential diagnosis of glioma recurrence and radiation-induced brain injury.Methods A total of 145 patients with glioma treated at Chinese People’s Armed Police Force Marine Police Corps Hospital from June 2015 to June 2018 were selected.All the patients underwent PET/CT and diffusion tensor MRI reexamination at 3 to 6 months after the radiotherapy.The clinical data,PET/CT and diffusion tensor imaging indices were compared.The receiver operating characteristic(ROC)curve was drawn to analyze the value of these indices in the differential diagnosis of glioma recurrence and radiation-induced brain injury.Results Standard uptake value(SUV),normal tissue ratio(L/N),regional cerebral blood volume(rCBV),regional cerebral blood flow(rCBF),choline/creatine ratio(Cho/Cr)and Cho/N-acetylaspartic acid ratio(Cho/NAA)were higher in patients with recurrent glioma than patients with radiation-induced brain injury(all P<0.05).The area under curve(AUC)for SUV,L/N,rCBV,rCBF,Cho/Cr and Cho/NAA in the differential diagnosis of glioma recurrence and radiation-induced brain injury was 0.874,0.828,0.952,0.928,0.853 and 0.905,respectively.AUC for rCBV was higher than that of L/N and Cho/Cr in the differential diagnosis of glioma recurrence and radiation-induced brain injury(all P<0.05).The best cut-off point for rCBV in the differential diagnosis of glioma recurrence from radiation-induced brain injury was 1.458,and the sensitivity and specificity was 90.8%and 94.1%,respectively.Conclusion SUV,L/N,rCBV,rCBF,Cho/Cr and Cho/NAA levels were significantly higher in patients with recurrent glioma than those with radiation-induced brain injury.Diffusion tensor imaging was superior to PET/CT in the differential diagnosis of recurrent glioma from radiation-induced brain injury,especially for rCBV.
作者
施晓林
王蕴华
申丹丹
SHI Xiao-lin;WANG yun-hua;SHEN Dan-dan(Department of Neurology,Chinese People's Armed Police Force Marine Police Corps Hospital,Jiaxing 314000,China)
出处
《中国肿瘤临床与康复》
2019年第12期1436-1439,共4页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
PET/CT
MRI弥散张量成像
脑胶质瘤复发
放射性脑损伤
PET/CT
Diffusion tensor magnetic resonance imaging
Recurrence of glioma
Radiation-induced brain injury