18FECH PET/CT脑显像在脑占位诊断中的价值分析

目的:由于大脑皮层对氟代脱氧葡萄糖(18F]fluoro-2-deoxy-D-glucose,18FDG)的高摄取影响其在脑占位诊断中的应用,而18F-乙基胆碱(18F]Fluoroethyl-dimethyl-2-hydroxyethylammonium,18FECH)在大脑皮层中低代谢,提高了对脑占位诊断的灵敏度和特异性.通过对18FECH正电子发射计算机断层显像(positron emission tomography and computer tomography,PET/CT)脑显像中的假阳性和假阴性分析,提高其对脑占位诊断的准确性.方法:38例脑占位同期行18FECH和18FDG PET/CT脑显像及MRI检查,在18FECH PET/CT脑显像中采用视觉分析方法,高于本底即为阳性,同时测定病灶的最大标准摄取值(maximal standard uptake value,SUVmax),病灶/对侧正常脑组织的SUVmax比值＞2作为阳性的诊断标准,反之为阴性,后经开颅手术或MRI引导下立体定位活检,术后病理证实和免疫组化分析,共有11例为假阳性和假阴性.结果:1.5例假阳性分别为1例结核性肉芽肿性炎,1例脑梗塞后坏死,1例血管畸形出血伴血管增生,1例髓鞘脱失性炎性病变和1例多发硬化性胶质增生.2.6例假阴性分别为1例胚胎发育不良性神经上皮瘤,2例WHO Ⅱ级星形细胞瘤,1例WHO Ⅱ级少突胶质细胞瘤,1例WHO Ⅱ级少突星形胶质细胞瘤和1例WHO Ⅲ级间变少突星形胶质细胞瘤.3.18FECH PET/CT脑显像在脑占位病变诊断的假阳性率为13.2%(5/38),假阴性率为15.8%(6/38),准确率为71.1%(27/38).结论:18FECH PET/CT脑显像可以清楚的显示病变的范围,对脑占位的定位和定性诊断有一定作用,但存在一定比例的假阳性和假阴性.

Analysis of false positive and false negative of 18FECH PET/CT in brain lesions

Objective:Because of the high uptake of18F]fluoro-2-deoxy-D-glucose(~(18)FDG)in brain, its disadvantage in brain lesion positron emission tomography and computer tomography(PET/CT) imaging,~(18)F]Fluoroethyl-dimethyl-2-hydroxyethylammonium(~(18)FECH)background uptake in brain was low,it could improve the sensitive and specificity of brain lesions diagnosis.We analyzed the false positive and false negative in ~(18)FECH PET imaging in brain lesions with the aim of improving the accuracy of diagnosis with ~(...