【摘要】 目的探讨正电子发射断层扫描(PET)显像在脑胶质瘤术前评估和PET神经导航脑胶质瘤切除术中的价值。方法50例胶质瘤行18F-脱氧葡萄糖(18F-FDG)、11C-蛋氨酸(11C-MET)PET检查,结果行视觉和半定量分析,并与病理分级和Ki67标记指数(Ki67LI)进行统计分析。10例胶质瘤在PET导航下行开颅手术。结果视觉分级:29例高级别胶质瘤中有27例18F-FDG高代谢,21例低级别胶质瘤中19例中、低代谢;除3例低级别胶质瘤表现为11C-MET低代谢外,其余均为高代谢。半定量分析:18F-FDG,除Ⅰ级与Ⅱ级之间无统计学差异外,其余各级间差异均有统计学意义(P<0.05);11C-MET,只有Ⅱ级与Ⅳ级之间差异有统计学意义(P<0.01),其余均无统计学差异。18F-FDG与11C-MET摄取均与Ki67 LI相关,11C-MET的相关性强于18F-FDG。PET显示脑胶质瘤的位置和边界清晰,并能揭示肿瘤增殖的不均一性,为神经导航提供了准确的肿瘤信息。结论PET在揭示胶质瘤增值活性和描述肿瘤界限有特殊优势;PET神经导航对提高部分肿瘤全切除率和揭示胶质瘤生物学特性有很高的价值。更多还原

【Abstract】 Objective To evaluate the application of positron emission tomography(PET) in preoperative estimation and neuronavigation-assisted resection of brain glioma.Methods Fifty patients with glioma were examined with both 18F-FDG and 11C-MET PET preoperatively.Ten tumors were resected under the guidance of PET neuronavigation.PET images were analysed in visual and semi-quantitative approaches and their correlations with with pathology and Ki67 LI were further analyzed.Results In visual analysis,27 cases exahbited 18F-FDG hypermetabolism of 29 high-grade gliomas and 19 displayed 18F-FDG iso-or hypometabolism of 21 low-grade tumors.All cases except 3 low-grade tumors had 11C-MET hypermetabolism.In semi-quantitative analysis,There were significant differences in 18F-FDG PET between grade Ⅰand Ⅲ,between gradeⅠand Ⅳ,betweenⅡand Ⅲ and between Ⅱand Ⅳ tumors(P<0.05).There was a significant difference in 11C-MET PET between grade Ⅱand Ⅳ tumors(P<0.01).Both 11C-MET and 18F-FDG PET imaging findings were positively correlated with the Ki67 LI.PET clearly revealed the location,extent and heterogeneity of the tumors and thus provided accurate data for neuronavigation system.Conclusions PET has special advantage in revealing the proliferation of the gliomas and delineating the tumor boundary.PET neuronavigation appears to have a great value in improving the completeness of the resection of the tumor,and also in revealing its biological character.更多还原