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目的探讨磁共振波谱(MRS)和~(11)C-蛋氨酸正电子发射显像(~(11)C-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~(11)C-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~(11)C-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~(11)C-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~(11)C-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。
Objective To investigate the value of MRS and ~ (11) C-methionine positron emission tomography (~ (11) C-MET PET) in the early diagnosis of supratentorial non-enhanced glioma. Methods Totally 65 patients with pathologically confirmed supratentorial non-enhanced glioma (T2 FLAIR high signal, no enhancement of T1 enhancement) were studied. Patients underwent both MRS and ~ (11) C-MET PET examinations before surgery, when one of them achieved a positive threshold (CNImax of 2.0 for maximal ratios of choline to acetylaspartate in MRS was 2.0; or ~ (11) The T / N value of tumor uptake value and normal brain tissue uptake value in C-MET PET was 1.3), which was diagnosed as glioma and compared with the pathological diagnosis of surgical specimens. Results The positive detection rate of MRS alone was 60.0%. The positive detection rate of ~ (11) C-MET PET alone was 78.5%. The positive detection rate of the two methods was 89.2%. The combined detection of the two methods showed that the positive detection rate was significantly different from that of single examination (P <0.05). Conclusions MRS and ~ (11) C-MET PET combined examination can significantly improve the positive rate of early diagnosis of supratentorial non-enhanced glioma, which has a high clinical value.