SPECT符合线路显像在脑胶质瘤术后随访中的应用研究

目的:探讨18F-FDG符合线路显像在脑胶质瘤术后残留或复发诊断中的应用价值。方法:正常对照8例,脑胶质瘤术后患者18例,其中术后残留或复发10例,术后无残留或复发者8例,最终诊断均经病理学及临床随访证实。所有患者均行18F-FDG符合线路SPECT显像。选择脑18F-FDG菜单进行采集条件设置,以COSEM进行三维图像重建,观察两组患者各断层面18F-FDG分布特点;采用感兴趣区技术,计算两组患者的肿瘤最大/白质平均计数比值(T/WM)。结果:8例术后无残留或复发者18F-FDG符合线路显像均为阴性;10例脑胶质瘤术后残留或复发组中18F-FDG显像阳性7例,假阴性3例,阳性率为70%,准确性为83.33%(15/18)。阳性结果的影像表现特征为原病灶的手术区出现点片状、环状18F-FDG摄取或摄取增高,T/WM比值为2.90±0.67;而术后无复发组其T/WM比值为1.09±0.06,两者比较有显著性差异(t=2.57,P<0.05)。结论:18F-FDG符合线路显像可用于脑胶质瘤术后残留或复发的早期诊断。

Application of SPECT coincidence detection imaging in diagnosing tumor residue or recurrence of intracranial glioma after surgery

Objective:To explore the application value of 18F-fluorodeoxyglucose(FDG)SPECT in diagnosing tumor residue or recurrence of post-operative brain glioma.Methods:8 normal controls and 18 cases patients with post-operation brain glioma were performed by 18F-FDG SPECT imaging.Of 18 patients,10 cases were tumor residue or recurrence,8 cases were no tumor residue or recurrence.The final diagnosis of tumor residue or recurrence was proved by pathology or clinical follow-up.The collecting condition was setuped by selecting brain 18F-FDG in menu.Three dimension imaging was reconstructed by COSEM program.The characteristic of 18F-FDG distributing on each piece image were observed in two group patient.Region of interested(ROI)technique was used.The ratio of tumor max /white matter mean(T/WM)was calculated in two group patients.Results:In normal controls,18F-FDG SPECT imaging were not seen abnormality.All cases in 8 patients group with no tumor residue or recurrence showed 18F-FDG SPECT negative.7 cases of the 10 patients group with tumor residue or recurrence showed 18F-FDG SPECT positive.The positive rate was 70%.3 cases were false negative.The accuracy of 18F-FDG SPECT was 83.33%(15/18).Imaging features of 18F-FDG SPECT positive showed 18F-FDG uptake or higher uptake with spots shape,patch shape and ring shape in operationlesions areas.T/WM was 2.90±0.67 in the group with tumor residue or recurrence,and T/WM was 1.09±0.06 in the group with no tumor residue or recurrence.t= 2.57,P<0.05.There was significant difference between two groups.Conclusion:18F-FDG SPECT imaging has great clinical valuable in diagnosing tumor residue or recurrence of post-operative brain glioma.