【摘要】 目的探讨磁共振波谱（MRS）和¹¹C-蛋氨酸正电子发射显像(¹¹C-MET PET)联合检查在幕上非强化胶质瘤早期诊断中的价值。方法 65例手术后经病理证实的幕上非强化胶质瘤（T2 FLAIR高信号,T1增强无强化）的患者为研究对象。患者术前同时接受MRS和¹¹C-MET PET两项检查,当其中一项达到阳性阈值(MRS中胆碱与乙酰天冬氨酸的比值最大值CNImax为2.0;或者¹¹C-MET PET中肿瘤摄取值和正常脑组织摄取值的T/N值为1.3)时即拟诊为胶质瘤,与手术标本病理诊断进行对照。结果单用MRS阳性检出率为60.0%,单用¹¹C-MET PET阳性检出率为78.5%,两种方法联合检查的阳性检出率达89.2%。两种方法联合检查的阳性检出率与单用一项检查方法比较,差异有统计学意义（P<0.05）。结论 MRS和¹¹C-MET PET联合检查可显著提高幕上非强化胶质瘤的早期诊断阳性检出率,具有较高的临床应用价值。更多还原

【Abstract】 Aim To investigate whether the combination of magnetic resonance spectroscopy（MRS） and ¹¹C-methionine positron emission tomography(¹¹C-MET PET) can increase the true positive rate of early diagnosis of non-enhancing supratentorial gliomas. Methods 65 patients with non-enhancing supratentorial lesions which were confirmed to be gliomas by surgery were enrolled in this study. Eachpatient underwent both MRS imaging and ¹¹C-MET PET scan prior to surgery. The lesion was considered as a glioma when either MRS or ¹¹C-MET PET results indicated the diagnosis [maximum Cho/NAA index（CNImax） higher than 2.0 in MRS or tumor versus normal tissue ratio（T/N ratio） higher than 1.3 in ¹¹C-MET PET]. The results of metabolic evaluation were compared with the pathologic diagnosis. Results The true positive rate of MRS imaging was 60.0%, the true positive rate of ¹¹C-MET PET was 78.5%. When combining the two examinations, 89.2% of patients were presumed to have gliomas by imaging diagnosis prior to surgery. The difference between the combination of the two examinations and the single examination was statistically significant（P<0.05）. Conclusion The combination of MRS and ¹¹C-MET PET can significantly elevate the true positive rate of early diagnosis of non-enhancing supratentorial gliomas, which is suitable and promising in clinical applications.更多还原