论著-头颈部
MRI结合PET-CT在脑 胶质瘤术前诊治中 的应用*
作者:徐大伟 马鹏举 高国军 黄立勇 王仲伟 金保哲 周文科
所属单位:新乡医学院第一附属医院神经外科 (河南 新乡 453000)
PDF摘要
目的 探讨磁共振成像(MRI)结合 正电子发射断层显像(PET-CT)在脑胶质瘤 术前诊断中的价值。方法 对我院神经外 科近两年(2016年3月-2018年3月)收治的 84例临床高度怀疑为脑胶质瘤患者术前 行MRI及PET-CT检查,以术后病理检查结 果为参考标准,评估单独MRI及MRI结合 PET-CT检查在脑胶质瘤术前诊断中的价 值。结果 84例患者术后病理证实为高级 别胶质瘤21例、低级别胶质瘤55例、脑胶 质瘤阴性8例,均为单发肿瘤;MRI对脑 胶质瘤术前诊断灵敏度、特异度、准确 性分别为96.05%(73/76)、100%(8/8)、 96.43%(81/84),评估脑胶质瘤分级的准 确性为75.00%(57/76),MRI结合PET-CT 对脑胶质瘤术前诊断的灵敏度、特异度、 准确性分别为98.69%(75/76)、100%、 98.81%(83/84),评估脑胶质瘤分级的准 确性为93.42%(71/76);MRI结合PET-CT对 脑胶质瘤术前评估的准确性显著优于单独 MRI检查(P<0.05)。结论 MRI结合PET-CT 对脑胶质瘤术前诊断的灵敏度、特异度和 准确率较高,可更准确评估肿瘤恶性程 度,提供脑胶质瘤更全面精确的信息,帮 助临床制定更科学合理的治疗方案,具有 较高的临床诊断价值。
Objective To explore the value of magnetic resonance imaging (MRI) combined with positron emission tomography (PET-CT) in the preoperative diagnosis of brain glioma. Methods A total of 84 cases of patients with high suspicion of brain glioma admitted to neurosurgery department of our hospital in the past two years (from March 2016 to March 2018) were given MRI and PET-CT before operation. The results of postoperative pathological examination were taken as reference to evaluate the value of separate MRI and MRI combined with PET-CT in the preoperative diagnosis of brain glioma. Results Postoperative pathology of 84 cases of patients confirmed 21 cases of highgrade glioma, 55 cases of low-grade glioma and 8 cases of negative glioma, and all were single tumors. The sensitivity, specificity and accuracy of MRI for preoperative diagnosis of brain glioma were 96.05% (73/76), 100% (8/8) and 96.43% (81/84) respectively, and the accuracy of glioma grading was 75.00% (57/76). The sensitivity, specificity and accuracy of MRI combined with PET-CT for preoperative diagnosis of brain glioma were 98.69% (75/76), 100% and 98.81% (83/84) respectively, and the accuracy of glioma grading was 93.42% (71/76). The accuracy of MRI combined with PET-CT was significantly better than that of MRI in the preoperative evaluation of glioma (P<0.05). Conclusion MRI combined with PET-CT has high sensitivity, specificity and accuracy in the preoperative diagnosis of glioma, and it can more accurately assess the degree of tumor malignancy, provide more comprehensive and accurate information of glioma, and help to formulate more scientific and reasonable treatment regimen in clinical practice, and it has a high clinical diagnostic value.
【关键词】脑胶质瘤;术前诊断;磁共振 成像;PET-CT
【中图分类号】R74;R81
【文献标识码】A
【DOI】 10.3969/j.issn.1672- 5131.2019.01.013
前言
脑胶质瘤是起源于神经上皮组织的颅内恶性肿瘤,临床较常见, 居于儿童恶性肿瘤的第二位,约占脑内肿瘤的40%~50%[1]。目前关于 胶质瘤的分级中最常用的为世界卫生组织(WHO)的分级系统[2],根据此 系统及病理表现,脑胶质瘤可分为低级别脑胶质瘤及高级别脑胶质瘤 两大类。近年来,脑胶质瘤的发病率逐年递增,增长率达1.2%/年,据 统计,我国脑胶质瘤年发病率达3-6人/10万人,死亡人数达3万/年, 提高脑胶质瘤的治疗效果对我国人民健康水平的提高至关重要[2]。脑 胶质瘤治疗方法包括手术、放疗、化疗、靶向治疗等,临床需要综合 考虑患者肿瘤位置、恶性程度、预后等情况采取个性化的治疗,对于 高度怀疑为脑胶质瘤的患者,临床常采用常规头部 CT及MRI检查脑胶 质瘤进行初步诊断,其对脑胶质瘤的恶性程度分级及预后判断价值还 有待提高[3],本实验拟采用MRI结合PET-CT检查,旨在探索更多有效途 径,为脑胶质瘤的术前诊断提供更准确全面的信息,提高脑胶质瘤的 治疗效果,具体如下。
中国CT和MRI杂志
第17卷, 第 1 期
2019年01月
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