摘要： 研究背景 随着多模态影像融合技术在临床的应用，11C-Met PET 与MRI 融合技术也应用于临床，本研究通过比较胶质瘤在11C-Met PET 与MRI 中不同影像显示结果，探讨11C-Met PET 与MRI 影像融合技术在脑胶质瘤外科手术前评价、术中导航和手术切除过程中的应用价值。方法 手术前于神经导航工作站对25例胶质瘤患者进行11C-Met PET 与MRI 影像融合，勾画肿瘤边界、计算肿瘤体积并进行分类。结果 据影像学分类，25例胶质瘤患者中1 例Ⅱ级、6 例Ⅲ级和8 例Ⅳ级MRI 所显示的肿瘤灶轮廓大部分位于PET 内（Ⅰ类）；2 例Ⅲ级PET 所显示的肿瘤灶轮廓大部分位于MRI 内（Ⅱ类）；6 例Ⅱ级和2 例Ⅲ级MRI 与PET 显示的病灶轮廓无从属关系（Ⅲ类）。结论 PET 在揭示胶质瘤增殖活性和描述肿瘤界限方面具有特殊优势，通过MRI 与PET 所显示的肿瘤轮廓关系，可用于术前初步预测肿瘤病理分级，有助于制定详细的手术计划。
关键词:
正电子发射断层显像术,
磁共振成像,
神经胶质瘤,
监测, 手术中
Abstract: Background With the development of image fusion technology in clinical application,the fusion of 11C-methionine (11C-Met) PET and MRI is also used in clinic. Based on different image results in 11C-Met PET and MRI of gliomas, this article aims to evaluate the application value of integration of MRI and 11C-Met PET in preoperative assessment, intraoperative neuronavigation and tumor resection of gliomasurgery. Methods Twenty-five patients with gliomas were examined with both MRI and 11C-Met PET before operation. Based on the integrated 11C-Met PET/MRI images, the neuronavigation workstation performed tumor delineation and calculated the tumor volume. Histological classification of tumors was performed according to WHO grades. The percentages of discrepancy-PET (vPET not included in vMRI) and discrepancy-MRI (vMRI not included in vPET) were evaluated on the fusion images. Results There were 3 11C-Met PET/MRI integration patterns emerged after analysis of volumetric data. One group included 15 cases (one was WHO Ⅱ, six were WHO Ⅲand eight were WHO Ⅳ) with vMRI included in vPET with a low discrepancy0MRI. The second one included 2 patients with WHOⅢgliomas with vPET included in vMRI with a low discrepancy-PET. The third group included 8 cases (six were WHOⅡand two were WHO Ⅲ) with vMRI-different-from-vPET. Conclusion 11C-Met PET is able to accurately delineate tumor boundary and sensitively target the region of high proliferation or metabolism. Different 11C-Met PET/MRI integration patterns can be assigned in tumor classfication and are favorable for making surgery plans.
Key words:
Positron-emission tomography,
Magnet ic resonance imaging,
Glioma,
Monitoring, intraoperation
韩志铁, 苏少波, 雪亮, 张川, 马俊, 王嘉拾, 岳树源. 11C-Met PET 与MRI 影像融合技术在胶质瘤术前评价和术中导航中的应用价值[J]. 中国现代神经疾病杂志, 2013, 13(4): 324-329.
HAN Zhi-tie, SU Shao-bo, XUE Liang, ZHANG Chuan, MA Jun, WANG Jia-shi, YUE Shu-yuan. Application of intergration of MRI and 11C-methionine PET in preoperative assessment and intraoperativeneuronavigation of glioma surgery[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2013, 13(4): 324-329.