18F-脱氧葡萄糖正电子发射断层扫描在垂体腺瘤诊断中的应用

目的探讨18F-脱氧葡萄糖(FDG)正电子发射断层扫描(PET)在垂体腺瘤影像诊断中的意义.方法回顾性分析29例垂体腺瘤病人的临床资料,其中垂体促肾上腺皮质激素(ACTH)腺瘤9例,泌乳素(PRL)腺瘤9例,生长激素(GH)腺瘤5例,无功能腺瘤5例,促甲状腺素(TSH)腺瘤1例;微腺瘤15例,大腺瘤11例,巨大腺瘤3例.比较MRI、18F-FDGPET检查结果及手术所见,并测量垂体腺瘤的标准摄取值(SUV),分析SUV与垂体腺瘤类型、大小、激素水平和生物学行为之间的关系.结果在18F-FDGPET显像中,垂体腺瘤表现为均匀的放射性摄取增高,与MRI和外科手术中发现的肿瘤位置相一致.在垂体大腺瘤和巨大腺瘤中,MRI和18F-FDG PET的检出率均为100%,而对15例垂体微腺瘤,MRI检出11例(73.3%),18F-FDG PET检出12例(80%),两者结合共检出14例(93.3%).SUV与垂体腺瘤大小、激素水平无明显相关性,而与垂体腺瘤类型和生物学行为有关.结论18F-FDG PET显像可以清晰地显示垂体腺瘤,与MRI结合可以提高垂体微腺瘤的阳性发现率.肿瘤侵犯周围结构者,其FDG摄取明显增高.

Use of 18F-FDG positron emission tomography for diagnosing pituitary adenoma

Objective To assess the diagnostic value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) for pituitary adenoma. Methods The clinic data of 29 patients with pituitary adenomas, including 9 corticotroph adenomas, 9 prolactinoma, 5 somatotroph adenomas, 5 nonfunctional adenomas and 1 thyrotroph adenoma; and 15 microadenomas, 11 macroadenomas, and 3 giant adenomas in terms of tumor size, were retrospectively analyzed. The results of 18F-FDG PET, MRI and operation were compared. Standard uptake value (SUV) was calculated and statistically analyzed for the relationship between the type, size, hormone level and biological behavior of pituitary adenomas. Results The pituitary adenomas showed homogeneously increased radioactivity uptake in 18F-FDG PET. The detection rates of macroadenomas and giant adenomas were all 100% in both MRI and 18F-FDG PET, and the locations of the tumors were consistent with the findings in operation. The rates of microadenomas were 73.3% and 80.0% in MRI and 18F-FDG PET respectively, but 93.3% when the two methods were combined. SUV was not significantly related to the size and hormone level, but related to the type and biological behavior of pituitary adenomas. Conclusion Pituitary adenomas could be showed clearly on 18F-FDG PET, and the combination of 18F-FDG PET with MRI could increase the detection rate of pituitary microadenomas. SUV increased in invasive pituitary adenomas.