【摘要】 目的探讨13N-NH3PET显像在脑星形细胞瘤中的诊断价值。方法30例拟诊胶质瘤患者,全部做了13N-NH3PET动态显像,其中17例患者同期完成了18F-FDGPET显像,所有患者均有MRI或CT检查结果,并且通过手术病理、穿刺活检或随访获得了临床最终诊断。由两位有经验的医师同时阅片,至少连续在两帧图像上出现无摄取或相对低的摄取为阴性,高度或中度摄取为阳性。结果15例星形细胞瘤中,14例13N-NH3PET显像阳性,灵敏度为93.3%,15例非星形细胞瘤中,11例为阴性,特异度为73.3%;诊断准确性为83.3%。同期MRI诊断灵敏度为66.7%。另18F-FDGPET显像6例,5例有阳性发现(83.3%)。肿瘤组织与正常脑白质放射性计数(T/WM)比值为0.97~2.49(1.94±0.41);非星形细胞瘤中,病灶组织与正常脑白质放射性计数(T/WM)比值为0.64~2.54(1.06±0.62)。两组比较有统计学差异。结论13N-NH3PET显像在脑星形细胞瘤的诊断中具有临床应用价值。更多还原

【Abstract】 Objective To evaluate the diagnostic value of ~ 13 N- ammonia PET imaging in astrocytomas. Methods Dynamic ~ 13 N- ammonia PET was performed in 30 patients with suspected brain gliomas. FDG PET was also performed in 17 of them within 2 weeks of each other. All patients were detected by CT or MRI. The final clinical results had been acquired by histopathological diagnosis, stereotatic biopsy or by following-up. All PET images were interpreted by two experienced nuclear physicians. Based on analysis the perfusion and delay’s images, at least two images, moderate uptake or intense uptake were defined as positive of visual interpretation (+), and faint uptake or no uptake were defined as negative results (-). For the semi-quantitative analysis, regions of interest were outlined on the site of maximum ~ 13 N- ammonia and white matter on PET images. Tumor-to-white matter (T/W) count ratios were calculated. Results The increased uptake of ~ 13 N- ammonia at the lesions was found in 14 of 15 astrocytomas, the sensitivity was 93.3%. Four non-astrocytomas were positive with ~ 13 N- ammonia, the specificity was 73.3%. The accuracy rate of diagnosis was 83.3%. MRI correctively diagnosed 10 gilomas in 15 cases. Five of six astrocytomas were positive with FDG PET, one of them did not uptake FDG. The average T/W ratio of ~ 13 N- ammonia in astrocytomas was 1.94±0.41. The average T/W ratio of ~ 13 N- ammonia in non-astrocytomas was 1.06± 0.62 . Conclusion There are substantial uptakes of ~ 13 N- ammonia in astrocytomas. ~ 13 N- ammonia PET may be useful in the diagnosis of astrocytoma.更多还原