目的头颈部解剖结构复杂、 血供丰富、各类器官密集，单模式影像 技术在临床诊断、鉴别诊断上有一定挑 战。本研究采用18F FDG PET/CT联合MRI高 b值DWI成像技术对头颈部肿瘤临床诊断 效能进行研究。方法 对27例临床诊断头 颈肿瘤患者进行18F FDG PET/CT联合MRI 高b值DWI成像。先进行PET/CT扫描，然 后进行MR常规序列和多b值扫描。分别在 工作站计算18F FDG PET/CT病灶标准摄取 值(standardized uptake value，SUV) 与多指数模型(小b值0-200、中b值300- 1500和高b值1700-4500s/mm2 )水分子扩散 成像表观扩散系数(apparent diffusion coefficient，ADC)。结果 18F FDG PET/ CT和MRI常规扫描序列均能发现患者头颈 部病灶。视觉诊断发现头颈部良性病灶在 b值大于3000时DWI上病灶信号均消失，而 恶性肿瘤病灶均仍呈现高信号。SUV值最 大值和平均值在良性和恶性病灶间存在显 著性差异(P<0.03)，而多b值扫描中仅高b 值ADC平均值存在显著性差异(P<0.02)。 SUV值与小、中和高b值的ADC值之间均无 明显相关性(r<0.47)。结论 高b值DWI成 像技术能够帮助对18F FDG PET/CT摄取病 灶进行良恶性的鉴别。

Objective Cerebral and cervical anatomy structure is complex, rich blood supply and various organs, single mode imaging techniques met challenges in clinical diagnosis and differential diagnosis. This research adopts the 18F FDG PET/CT in combination with MRI high b values DWI imaging of head and neck cancer clinical diagnosis can efficiency were studied. Methods A total of 27cases of clinical diagnosis with head and neck cancer patients accepted 18F FDG PET/CT in combination with MRI (high b DWI) imaging scan. PET/CT scan first, and then to MR conventional sequence and multi b scan. Respectively in the workstation calculation of 18F FDG PET/CT lesions standard perturbation values (standardized uptake value, SUV) with single index (0,1000s/mm2 ) and multiple index model (small b 0-200,middle b 300-1500 and high b, 1700-4500 s/mm2 ) a water molecule diffusion imaging apparent diffusion coefficient (ADC). Results 18F FDG PET/CT and routine MRI scanning sequences were found in patients with head and neck lesions. Visual detection head and neck when b is greater than 3000 s/mm2 benign lesions DWI lesions on signal can have disappeared, and malignant lesions are present high signal. SUV maximum and average have significant statistical difference between benign and malignant lesions(P<0.03), and the number of b scan only high b values exist significant difference(P<0.02). No significant correlations were found between SUV and b value of ADC values(P<0.47). Conclusion The high value of DWI imaging technology can b can help of 18F FDG PET/CT intake in the identification of benign and malignant lesions.