摘要
目的研究PET/MR一体机所得参数对脑肿瘤的诊断效能，探讨多模态显像诊断脑肿瘤的价值。方法前瞻性选择2012年11月至2015年9月间28例（男21例、女7例，年龄6～82岁）临床怀疑脑占位行PET/MR多模态脑显像检查的患者。患者均同机采集11C－MET PET序列及MR多序列。评估PET/MR各序列及多模态融合图像，测量并记算病灶的SUVmax、ADCmean、rCBF及NAA/（Cho＋Cre）比值。以病理或临床最终诊断为标准，计算各方法ROC曲线及诊断准确性。根据各项参数的最佳阈值，判断病变并获得4项参数的组合分值，计算组合后方法的诊断效能。采用两样本t检验进行比较。结果SUVmax、ADCmean、rCBF及NAA/（Cho＋Cre）比值的诊断准确性分别为89.3%（25/28）、82.1%（23/28）、78.6%（22/28）和75.0%（21/28），SUVmax的诊断准确性最高；组合诊断效能更优。10例胶质瘤患者及11例炎性病变患者的SUVmax、rCBF及NAA/（Cho＋Cre）比值的组间差异均有统计学意义（t值：－2.31、－3.11和－2.77，均P〈0.05）。结论利用PET/MR可以一站式采集脑部的多模态序列，所获得的SUVmax、ADC、rCBF及NAA/（Cho＋Cre）比值各项参数及其组合对脑肿瘤有较好的定性诊断价值，其中多模态组合诊断更有优势。
Objective To evaluate the diagnostic efficiency of the parameters obtained from PET/MR in brain tumors. Methods In this prospective study, 28 patients （21 males, 7 females, age range： 6-82 years） with clinical suspicion of brain tumor from November 2012 to September 2015 underwent PET/MR muhi-modality imaging. The examination of PET/MR included ^11C-MET PET and multiple MR sequences. The qualities of images were estimated firstly. The ROC curve and the accuracy of SUVmax, ADC rCBF and NAA/（Cho＋Cre） ratio were calculated. The pathology or final clinical diagnosis was taken as the standard. The diagnostic efficiency of the multi-modality imaging was determined based on the cutoff values of the four parameters. Two-sample t test was used to analyze the differences of parameters between glioma group and inflammatory group. Results SUVmax, ADC rCBF and NAA/（Cho＋Cre） ratio were validated to be effective parameters in diagnosing brain tumors with the diagnostic accuracy of 89.3 % （ 25/28）, 82.1% （23/ 28）, 78.6% （22/28） and 75.0% （21/28）, respectively. The SUVmax exhibited the highest diagnostic accuracy, while the diagnostic efficiency of the combination of four parameters was superior to the separate parameter. The values of SUVmax, rCBF and NAA/（Cho＋Cre） ratio were significantly different between glioma group （ n = 10） and inflammatory group （ n = 11 ; t values ： - 2.31, - 3.11, - 2.77, all P 〈 0. 05 ）. Conclusions PET/MR can provide a one-stop examination with muhi-modality imaging of brain. The obtained parameters SUVmax, ADC rCBF and NAA/（Cho＋Cre） ratio, especially their combination, have effective diagnostic values on brain tumor.
出处
《中华核医学与分子影像杂志》
北大核心
2017年第9期527-531,共5页
Chinese Journal of Nuclear Medicine and Molecular Imaging
关键词
脑肿瘤
正电子发射断层显像术
磁共振成像
甲硫氨酸
Brain neoplasms
Positron-emission tomography
Magnetic resonance imaging
Methionine
