CAJ | 학술논문

目的：比较并探讨增强MRI和18F-脱氧葡萄糖-正电子发射断层扫描（18F-FDG PET-CT）对胶质瘤术后复发病灶诊断结果。方法选取2002年5月至2011年5月已经病理学证实，并在以后治疗和随访过程中怀疑复发的胶质瘤患者94例。手术切除后结合化疗的为53例，切除后结合放疗和化疗的为35例，只是手术治疗或只是放疗的为6例。对怀疑复发的所有病例均行增强MRI和18 F-FDG PET-CT 影像学检查。统计学比较采用 Mc-Nemar检验。结果 M RI真阳性结果为53例（Ⅳ级8例，Ⅲ级25例，Ⅱ级17例，Ⅰ级3例），假阴性为7例（Ⅳ级1例，Ⅲ级1例，Ⅱ级1例，Ⅰ级4例）；18 F-FDG PET-CT真阳性结果为29例（Ⅳ级2例，Ⅲ级14例，Ⅱ级10例，Ⅰ级3例），假阴性为14例（Ⅳ级3例，Ⅲ级2例，Ⅱ级5例，Ⅰ级4例）。M RI对脑胶质瘤复发检出的敏感度较高为93．55％，特异度18．75％。而18 F-FDG PET-CT的特异度67．44％和敏感度92．16％。通过总体和不同分级之间的比较，增强MRI与18 F-FDG PET-CT一致的共有43例，结果不一致的有51例。统计结果表明，两者差异有统计学意义（χ2＝8．50，P＝0．013）。结论18 F-FDG PET-CT的敏感度较低，不建议作为检查复发的初级筛选手段。但可以在经过MRI检查出病灶后，再通过18 F-FDG PET-CT进行一定特性描述的检查。
목적：비교병탐토증강MRI화18F-탈양포도당-정전자발사단층소묘（18F-FDG PET-CT）대효질류술후복발병조진단결과。방법선취2002년5월지2011년5월이경병이학증실，병재이후치료화수방과정중부의복발적효질류환자94례。수술절제후결합화료적위53례，절제후결합방료화화료적위35례，지시수술치료혹지시방료적위6례。대부의복발적소유병례균행증강MRI화18 F-FDG PET-CT 영상학검사。통계학비교채용 Mc-Nemar검험。결과 M RI진양성결과위53례（Ⅳ급8례，Ⅲ급25례，Ⅱ급17례，Ⅰ급3례），가음성위7례（Ⅳ급1례，Ⅲ급1례，Ⅱ급1례，Ⅰ급4례）；18 F-FDG PET-CT진양성결과위29례（Ⅳ급2례，Ⅲ급14례，Ⅱ급10례，Ⅰ급3례），가음성위14례（Ⅳ급3례，Ⅲ급2례，Ⅱ급5례，Ⅰ급4례）。M RI대뇌효질류복발검출적민감도교고위93．55％，특이도18．75％。이18 F-FDG PET-CT적특이도67．44％화민감도92．16％。통과총체화불동분급지간적비교，증강MRI여18 F-FDG PET-CT일치적공유43례，결과불일치적유51례。통계결과표명，량자차이유통계학의의（χ2＝8．50，P＝0．013）。결론18 F-FDG PET-CT적민감도교저，불건의작위검사복발적초급사선수단。단가이재경과MRI검사출병조후，재통과18 F-FDG PET-CT진행일정특성묘술적검사。
Objective To compare and investigate the diagnostic value of the enhanced MRI and 18 F-FDG PET in recurrence lesions of lioma .Methods 94 cases of glioma confirmed by the pathology and suspected recurrrence during subsequent treatment and follow up period from May 2002 to May 2011 were selected as the study subjects .53 cases were performed the surgical excision combined with chemotherapy ,35 cases were treated by surgical excision combined with radiotherapy and chemotherapy and 6 cases were treated only by surgical excision or radiotherapy .All cases of suspected recurrence underwent both preoperative enhanced MRI and 18 F-FDG PET imaging .The statistical comparison was conducted by the McNemar test .Results The true positive results of MRI were 53 cases(8 cases of the grade Ⅳ ,25 cases of the grade Ⅲ ,17 cases of the gradeⅡ ,3 cases of the gradeⅠ);the false negative results were 7 cases(1 case of the grade Ⅳ ,1 case of the grade Ⅲ ,1 case of the gradeⅡ ,4 case of the gradeⅠ);the true positive results of 18 F-FDG PET were 29 cases(2 cases of the grade Ⅳ ,14 cases of the grade Ⅲ ,10 cases of the gradeⅡ ,3 ca-ses of the gradeⅠ);the false negative results were 14 cases(3 cases of the grade Ⅳ ,2 cases of the grade Ⅲ ,5 cases of the gradeⅡ ,4 case of the gradeⅠ) .The sensitivity of MRI in detecting brain glioma recurrence was 93 .55% ,but the specificity was 18 .75% .And the specificity of 18 F-FDG PET was 67 .44% and its sensitivity was 92 .16% .Through the overall and the comparison among different grades ,the consistent results of MRI and 18 F-FDG PET had 43 cases , while the inconsistent results had 51cases ,the results revealed that the difference between enhanced MRI and 18 F-FDG PET/CT had statistical significance(χ2 = 8 .50 ,P= 0 .013) .Conclusion The sensitivity of 18F-FDG PET is lower ,it was not recommended as primary screening method for detecting recurrence .But after detecting lesions by MRI ,the characterization examination could be performed by 18 F-FDG PET-CT .