多发性硬化PET代谢显像与MRI和病理对照研究

目的 比较磁共振成像(MRI)检查和正电子发射断层显像(PET)及病理对判定脑内多发性硬化(MS)，尤其是脱髓鞘假瘤及疾病分期的价值。方法 经临床明确诊断的MS2例．均经过MRI扫描，T1、T2加权，行PET显像，将两者进行比较，其中1例病灶做病理检查。结果 2例MRI扫描T1WI表现为低信号．T2WI可见明确高信号，例2呈团块状。PET显像：例1右侧顶叶、左侧小脑半球等处可见形态欠规则的稍高代谢灶；例2左侧顶叶、颞叶及枕叶皮层及皮层下显示较大范围代谢降低区。病理学检查证实病灶处有大量泡沫样细胞(CD68^ )及增生的胶质细胞，病灶区血管周围T淋巴细胞浸润呈套袖状，髓鞘染色显示髓鞘脱失。结论 使用PET技术可辅助判定脑内白质区病灶是急性期还是非急性期，并可协助鉴别脱髓鞘假瘤与颅内肿瘤，同时能为MS患者脑功能异常与病蛮的范围的关系提供良好依据。

Contribution of 18F-FDG PET and MRI to the Pathological Examinations in Patients with Multiple Sclerosis

Objective To evaluate the application of 18F-FDG PET and comparing with MRI tests to pathological examinations in multiple sclerosis, especially in demyelinating pseudotumor and the course of the disease. Methods Two patients clinically verified multiple sclerosis, had PET and MRI tests performed and followed with pathologic examination for intra cranial sclerosis state and disease staging.Results MR imaging demonstrated low signal on T1-weight and high signal on T2-weight. PET showed mild increase of oxygen metabolism in the right parietal lobe and left cerebellum in case 1 and general reduction of oxygen metabolism in the left parietal, temporal and occipital cortex in case 2.On the pathological examination, CD68+ was stained for a mass of macrophages around the vessel. HE stained for gelatinous fiber hyperplasia, perivascular cuffing of lymphocyte infiltration. Luxol fast blue stain showed demyelination. Conclusions PET will help to definite the course of the lesion in the white matter and differentiate the demyelinating pseudotumor from the tumor, at the same time, it provides the correlations between the functional abnormalties and the wide range of the disease.