幕上肿瘤所致交叉性小脑失联络^(18)F-FDG PET/CT显像分析

^(18)F-FDG PET/CT imaging of crossed cerebellar diaschisis induced by supratentorial tumors

目的探讨幕上肿瘤所致交叉性小脑失联络(crossed cerebellar diaschisis,CCD)发生机制及18F-FDG PET/CT显像特点。方法回顾性分析2017年1月至2021年6月行^(18)F-FDG PET/CT全身显像的86例幕上占位患者,观察并记录幕上病灶位置、数量、大小、SUVmax值、CT值、与基底节关系、是否伴发水肿等情况及小脑不对称指数(asymmetry index,AI)。比较CCD患者与非CCD患者间显像差异,分析幕上病灶SUVmax、最大径与小脑AI相关性。采用SPSS 21.0软件进行统计分析。统计学方法采用卡方检验、独立样本t检验、Pearson相关分析。结果86例患者中CCD患者14例,非CCD患者72例,CCD发生率16.3%;CCD患者与非CCD患者原发灶是否累及基底节区差异有统计学意义(χ^(2)=7.637,P=0.006);CCD患者小脑AI[(0.27±0.09),(0.05±0.02),t=6.847,P=0.003]、原发灶最大径[(3.98±1.09)cm,(2.36±1.61)cm,t=2.011,P=0.040]均大于非CCD患者。CCD患者小脑AI与原发灶最大径存在显著正相关(r=0.375,P=0.028)。结论18F-FDG PET/CT显像能辅助诊断交叉性小脑失联络。幕上肿瘤原发灶累及基底节区更易导致交叉性小脑失联络,原发灶大小与小脑AI具有相关性。

Objective To investigate the mechanism of crossed cerebellar diaschisis(CCD)induced by supratentorial tumors and the characteristics of 18F-FDG PET/CT imaging.Methods Eighty-six patients with supratentorial tumors who underwent 18F-FDG PET/CT whole-body imaging from January 2017 to June 2021 were retrospectively analyzed.Placement,number,size,SUVmax,CT values,relationship with basal ganglia,edema,and cerebellar asymmetry index(AI)were observed and recorded.The imaging differences between patients with CCD and patients without CCD were compared,and the correlations between SUVmax,maximum diameter and cerebellar AI were analyzed.SPSS 21.0 software was used for statistical analysis.Chi-square test,independent sample t-test and Pearson correlation analysis were used for data statistics.Results Among the 86 patients,14 were patients with CCD and 72 were patients without CCD.The incidence of CCD was 16.3%.There were statistically significant differences in whether the primary lesions involved the basal ganglia region between patients with CCD and patients without CCD(χ^(2)=7.637,P=0.006).The cerebellar AI((0.27±0.09),(0.05±0.02),t=6.847,P=0.003)and maximum diameter of primary lesions((3.98±1.09)cm,(2.36±1.61)cm,t=2.011,P=0.040)in patients with CCD were both larger than those in patients without CCD.There was a significant positive correlation between cerebellar AI and the maximum diameter of primary lesions in patients with CCD(r=0.375 P=0.028).Conclusion 18F-FDG PET/CT imaging can assist in the diagnosis of crossed cerebellar diaschisis.The primary lesion of supratentorial tumor involving the basal ganglia is more likely to cause crossed cerebellar diaschisis,and the size of the primary lesion is correlated with cerebellar AI.