^(18)F-FDG、^(18)F-FMZ PET/CT对局灶性皮质发育不良的定位诊断价值

Diagnostic value of^(18)F-FDG and^(18)F-FMZ PET/CT in the localization of focal cortical dysplasia

目的比较发作间期^(18)F-FDG及^(18)F-氟马西尼(FMZ)PET/CT显像对局灶性皮质发育不良(FCD)的定位准确性。方法回顾性分析2021年7月至2023年6月于复旦大学附属华山医院经过手术切除、病理证实的FCD患者22例(男12例,女10例;年龄8~36岁)。患者在行手术切除前均行^(18)F-FDG、^(18)F-FMZ PET/CT检查,以术后病理诊断为"金标准",采用视觉评分的方法分析图像,比较2种显像方法对于FCD定位的准确性,并进一步行不同病理类型(FCDⅡa、FCDⅡb)亚组分析。采用配对t检验、χ2检验或Fisher确切概率法分析数据。结果^(18)F-FMZ PET/CT的视觉评分高于^(18)F-FDG(3.00±0.82与2.27±0.92;t=4.17,P=0.020)。^(18)F-FMZ PET/CT的定位准确性为77.27%(17/22),高于^(18)F-FDG PET/CT[36.36%(8/22);χ2=7.50,P=0.006]。亚组分析示,^(18)F-FMZ PET/CT在FCDⅡa患者(18例)中的定位准确性高于^(18)F-FDG(15/18与6/18;P=0.006)。结论相比于^(18)F-FDG,^(18)F-FMZ PET/CT对于病灶边界识别较为清晰准确,准确性较高,对于术前准确定位有一定的指导意义。

ObjectiveTo compare the localization accuracy of interictal ^(18)F-FDG and ^(18)F-flumazenil(FMZ)PET/CT imaging for focal cortical dysplasia(FCD).MethodsA retrospective analysis was conducted on 22 patients(12 males,10 females;age 8-36 years)with pathologically confirmed FCD who underwent surgical resection at Huashan Hospital,Fudan University from July 2021 to June 2023.All patients underwent ^(18)F-FDG and ^(18)F-FMZ PET/CT scans before surgery.Surgical pathological diagnosis was used as the gold standard.Visual scoring was used to analyze the images.The accuracy of the two imaging methods in the localization of FCD was compared,and subgroup analysis(FCDⅡa,FCDⅡb)of different pathological type was further performed.Paired-t test,χ2 test or Fisher′s exact test was used to analyze the data.ResultsThe visual score of ^(18)F-FMZ PET/CT was higher than that of ^(18)F-FDG(3.00±0.82 vs 2.27±0.92;t=4.17,P=0.020).The accuracy of interictal ^(18)F-FMZ PET/CT was 77.27%(17/22),which was higher than that of ^(18)F-FDG PET/CT(36.36%,8/22;χ2=7.50,P=0.006).Subgroup analysis showed that within the cohort of patients diagnosed with FCDⅡa(n=18),^(18)F-FMZ PET/CT outperformed ^(18)F-FDG in terms of accuracy for localization(15/18 vs 6/18;P=0.006).ConclusionCompared to ^(18)F-FDG,^(18)F-FMZ PET/CT demonstrates clearer and more accurate identification of lesion borders,and exhibits higher precision,which provides valuable guidance for preoperative localization.