【摘要】 目的研究磁共振波谱（MRS）与¹⁸F-乙基酪氨酸正电子发射断层成像(¹⁸F-FET-PET)联合应用在诊断幕上非强化胶质瘤的应用价值。方法对98例MRI诊断疑似胶质瘤患者的幕上非强化病灶在治疗前行MRS和¹⁸F-FET-PET代谢影像学检查。当¹⁸F-FET-PET或MRS检查结果达到预设阈值时,则该病例的代谢影像学诊断定性为胶质瘤。对患者的治疗前代谢影像学诊断与术后病理诊断或内科临床诊断结果进行比较。结果单独使用¹⁸F-FETPET诊断的灵敏度和特异度分别为73.1%和70.0%,单独使用MRS诊断的灵敏度和特异度分别为57.7%和60.0%。MRS和¹⁸F-FET-PET联合检查结果进行综合判定,诊断灵敏度提高至84.6%,特异度降低至50.0%。统计学分析显示,两种方法联合检查的灵敏度与单独使用MRS或¹⁸F-FET-PET比较,差异有统计学意义(MRS,P<0.001;¹⁸F-FET-PET,P=0.004),而特异度的差异无统计学意义(MRS,P=0.500;¹⁸F-FET-PET,P=0.125)。结论在疑似胶质瘤的幕上非强化病灶的诊断中,MRS和¹⁸F-FET-PET联合检查可显著提高诊断的敏感度,并在统计学上保持相同的特异度。更多还原

【Abstract】 Aim To explore the practical value of combining magnetic resonance spectroscopy（MRS） and ¹⁸F-fluoro-ethyl-L-tyrosine positron emission tomography(¹⁸F-FET-PET) for diagnosis of non-enhancing supra-tentorial gliomas. Methods Ninety-eight patients with non-enhancing supratentorial lesions were enrolled in the research. MRS and ¹⁸F-FET-PET were all finished before the treatment. When ¹⁸F-FET-PET or MRS results exceed preliminary threshold, the lesion was supposed to be a glioma. Comparison was subsequently started between the radiological diagnoses and pathological diagnoses or clinical diagnoses. Results Diagnostic sensitivity and specificity reached 73.1% and 70.0% for ¹⁸F-FET-PET, while 57.7% and 60.0% for MRS, respectively. Meanwhile, combination of MRS and ¹⁸F-FET-PET improved the diagnostic sensitivity to 84.6% while lowered specificity to 50.0%. Statistical analysis proved significant differences in diagnostic sensitivity between the combination and MRS or ¹⁸F-FET-PET alone(84.6% vs. 57.7% for MRS, P<0.001; 84.6% vs. 73.1% for ¹⁸F-FET-PET, P=0.004). Nevertheless, significant differences failed to be proved in specificity between the combination and MRS or ¹⁸F-FET-PET alone(50.0% vs. 60.0% for MRS, P=0.500; 50.0% vs. 70.0% for ¹⁸F-FET-PET, P=0.125). Conclusion For non-enhanced supra-tentorial gliomas, combining MRS and ¹⁸F-FET-PET considerably improves the diagnostic sensitivity as well as maintaining the same specificity statistically in comparison with MRS or ¹⁸F-FET-PET alone.更多还原