闫峰山;尤阳;轩昂;付畅;李会强;王莉;徐俊玲;

• 1:河南省人民医院郑州大学人民医院
• 2:河南医学科学院

摘要(Abstract)：

目的探讨⁽¹⁸⁾F-脱氧葡萄糖((18)F-脱氧葡萄糖(⁽¹⁸⁾F-fluorodeoxyglucose,(18)F-fluorodeoxyglucose,⁽¹⁸⁾F-FDG)正电子发射计算机断层扫描(positron emission tomography/computed tomography,PET/CT)联合功能磁共振成像(function magnetic resonance imaging,fMRI)在原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)中的诊断价值。方法回顾性分析17例PCNSL患者PET/CT影像学特征[最大标准摄取值(standard uptake value maximum,SUVmax),平均标准摄取值(standard uptake value maximum mean,SUVmean)]及其中10例患者功能磁共振影像学特征[磁共振扩散加权成像(diffusion weighted imaging,DWI),磁共振灌注成像(perfusion weighted imaging,PWI)],同时统计14例Ⅲ～Ⅵ级胶质瘤和14例脑转移瘤患者PET/CT影像学特征(SUVmax、SUVmean),绘制PCNSL组与脑胶质瘤、转移瘤联合组的SUVmax及SUVmean受试者工作特征曲线(receiver operator characteristic curve,ROC),确定诊断最优阈值,观察10例原发性中枢神经系统淋巴瘤患者ADC病灶平均值与SUVmax及SUVmean的相关性。结果 17例淋巴瘤组共28个病灶,10例具有MRI影像资料患者,共15个病灶。淋巴瘤组与胶质瘤、转移瘤联合组SUVmax(t=0)、SUVmean(t=0)差异有统计学意义。根据ROC曲线分析,SUVmax曲线下面积AUC:0.836,取截断值SUVmax为17.55时,敏感性0.765,特异性0.821;SUVmean曲线下面积AUC:0.853,取截断值SUVmean为11.9时,敏感性0.882,特异性0.75。10例具有MRI影像资料的PCNSL患者,病灶PWI呈低灌注13例,等灌注2例,DWI弥散受限,且平均ADC值与SUVmax(r=—0.725,P=0.018)及SUVmean(r=—0.666,P=0.036)呈负相关。结论原发性中枢神经系统淋巴瘤(18)F-FDG)正电子发射计算机断层扫描(positron emission tomography/computed tomography,PET/CT)联合功能磁共振成像(function magnetic resonance imaging,fMRI)在原发性中枢神经系统淋巴瘤(primary central nervous system lymphoma,PCNSL)中的诊断价值。方法回顾性分析17例PCNSL患者PET/CT影像学特征[最大标准摄取值(standard uptake value maximum,SUVmax),平均标准摄取值(standard uptake value maximum mean,SUVmean)]及其中10例患者功能磁共振影像学特征[磁共振扩散加权成像(diffusion weighted imaging,DWI),磁共振灌注成像(perfusion weighted imaging,PWI)],同时统计14例Ⅲ～Ⅵ级胶质瘤和14例脑转移瘤患者PET/CT影像学特征(SUVmax、SUVmean),绘制PCNSL组与脑胶质瘤、转移瘤联合组的SUVmax及SUVmean受试者工作特征曲线(receiver operator characteristic curve,ROC),确定诊断最优阈值,观察10例原发性中枢神经系统淋巴瘤患者ADC病灶平均值与SUVmax及SUVmean的相关性。结果 17例淋巴瘤组共28个病灶,10例具有MRI影像资料患者,共15个病灶。淋巴瘤组与胶质瘤、转移瘤联合组SUVmax(t=0)、SUVmean(t=0)差异有统计学意义。根据ROC曲线分析,SUVmax曲线下面积AUC:0.836,取截断值SUVmax为17.55时,敏感性0.765,特异性0.821;SUVmean曲线下面积AUC:0.853,取截断值SUVmean为11.9时,敏感性0.882,特异性0.75。10例具有MRI影像资料的PCNSL患者,病灶PWI呈低灌注13例,等灌注2例,DWI弥散受限,且平均ADC值与SUVmax(r=—0.725,P=0.018)及SUVmean(r=—0.666,P=0.036)呈负相关。结论原发性中枢神经系统淋巴瘤⁽¹⁸⁾F-FDG PET/CT摄取程度高于胶质瘤组和转移瘤组,且SUVmax 17.55和SUVmean 11.9可作为参考诊断阈值,指导淋巴瘤与其他颅内常见肿瘤(胶质瘤和转移瘤)的鉴别,结合其功能MRI弥散受限及灌注减低等特点更有助于提高PCNSL诊断特异性。

关键词(KeyWords)： 原发性中枢神经系统淋巴瘤;~(18)F-脱氧葡萄糖;正电子发射断层显像术;体层摄影术,X线计算机;功能磁共振成像

Abstract:

Keywords:

基金项目(Foundation): 河南省医学科技攻关计划(编号:SBGJ202002007)

作者(Authors): 闫峰山;尤阳;轩昂;付畅;李会强;王莉;徐俊玲;

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