摘要
目的观察正电子扫描（PET）-MRI影像融合技术在胶质瘤的活组织检查和手术治疗方面的应用价值。方法收集北京协和医院神经外科2010年1月至2011年4月术前怀疑为胶质瘤的患者，共18例。术前行头颅MRI及PET扫描，将三维数据在图形工作站融合，分别在MRI、脱氧葡萄糖（FDG）PET及乙基胆碱（FECH）PET图像上勾画肿瘤轮廓，根据3种轮廓及术中所见综合决定手术切除范围或活组织检查靶点。结果在PET上，胶质母细胞瘤中示踪剂的SUV＂均值大于Ⅱ-Ⅲ级胶质瘤。在先行活组织检查后行肿瘤切除的患者，根据PET选取的活组织检查靶点与切除标本的病理结果相符。在接受肿瘤切除术的11例患者中，FDG及FECHPET的贡献比例分别6／11和3／11，二者结合的贡献比例9／11。结论PET．MRI融合技术能够准确勾画肿瘤边界并显示瘤内代谢增殖活性较高的区域．对提高胶质瘤疗效有很高的价值。
Objective To assess the value and feasibility of positron-emission tomography-magnetic resonance imaging （PET-MRI） fusion technology in delineating tumor boundaries and positioning biopsy targets of gliomas so as to facilitate the diagnosis and treatment of gliomas. Methods A total of 18 patients with a preoperative diagnosis of gliomas discharged from our hospital from January 2010 to April 2011 were recruited. All of them underwent the preoperative examinations of MRI, fluorodeoxyglucose （FDG） PET and fluoroethyl-choline （FECH） PET. The digital image data were transferred into Brain LAB planning software and three types of images automatically fused. The tumor contours were drawn on the basis of each image modality separately. The extent of tumor resection or biopsy target was determined on the integrated information including tumor contours on PET and MRI images and intraoperative observation of tumor texture. Results On PET scans, the average standard uptake value （SUV） of glioblastomas was higher than that of gradeⅡ - Ⅲ gliomas. With regard to the patients with both biopsy and tumor resection, the pathological diagnosis of the specimen obtained from the PET-guided biopsy was consistent with that of subsequently resected tissue. All 11 patients undergoing tumor resection were classified according to relationship between the image-based tumor contour and actual extent of resection. Six of them benefited from contour delineated by FDG PET images and 3 of them benefited from FECH PET. The combined contribution ratio of both PET methods was 9/11. Conclusion PET-MRI fusion technology may accurately delineate tumor boundary and sensitively target the region of high proliferation or metabolism. A more radical resection and more accurate histological diagnosis can be thus achieved and yield a probably better prognosis of gliomas.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2013年第1期15-18,共4页
National Medical Journal of China
