摘要
目的探讨一体化PET/MR在儿童肿瘤诊断中的应用价值,并比较其与PET/CT的诊断差异,为PET/MR在儿童肿瘤中的应用提供依据。方法回顾性分析50例儿童恶性肿瘤患者的相关资料。先后行全身氟代脱氧葡萄糖(18F-FDG)PET/CT显像及PET/MR显像。以病理及临床诊断结果为金标准。用Pearson相关性分析、Bland-Altman分析及t检验对两者的最大标准摄取值(SUVmax)、信噪比(SNR)及靶本比(T/B)进行比较分析;运用χ2检验比较各指标诊断效能的差异。结果50例病例中,共发现386个病灶,有341个病灶在PET/MR和PET/CT上均呈高摄取。其余45个PET阴性病灶中,CT阳性而MR阴性的6个病灶,其中有4个来自于肺,2个来自于椎体;MR阳性而CT阴性的9个病灶,其中肝脏4个、脑3个、乳腺2个。两台设备的PET的阳性率无统计学差异(χ2=0.61,P>0.05)。PET/MR图像比PET/CT本底摄取更低,SNR更高,均值差为1.9(95%CI:-2.8~6.6),具有统计学差异(t=4.17,P<0.05);Bland-Altman分析显示,PET/MR显示病灶的SUVmax-MR高于PET/CT的SUVmax-CT,均值差为1.6(95%CI:-0.8~4.0),具有统计学差异(t=2.94,P<0.05),两者具有很好的一致性(r=0.932);PET/MR图像T/B值较PET/CT高,均值差为3.1(95%CI:-6.7~12.9),有显著统计学差异(t=3.16,P<0.05)。PET/MR在显示软组织脏器阳性病灶的清晰度优于PET/CT,PET/MR能够更清楚地显示肿瘤的内部结构,以及与周边组织的关系;而PET/CT在肺、骨等方面的病灶显示优于PET/MR。但两台设备诊断结果无明显统计学差异(χ2=1.04,P>0.05)。结论PET/MR与PET/CT在儿童肿瘤患者中显示出相同的病变检出率。PET/MR的图像SNR更高、分辨率更好,对于肝、脑及其他软组织器官中病灶的评估PET/MR更具优势。
Objective To compare and investigate the value of a Hybrid TOF PET/MR in the diagnosis of childhood tumors,and to compare the diagnostic difference with PET/CT,and provide evidence for the application of PET/MR in children’s tumors.Methods 50 patients with confirmed primary childhood malignant tumors and clinically suspected of distant metastases,were performed whole body 18F-FDG PET/CT imaging and 18F-FDG PET/MR(T1,T2 and DWI)localized examination on the same day.The pathological and clinical diagnosis results were the gold standard for diagnosis.The Pearson correlation analysis,Bland-Altman analysis and t test were applied to analyze the SUVmax、SNR and the T/N values in two PET imaging;theχ2 test was conducted to compare the diagnostic efficacy between PET/CT and PET/MR.Results In the 50 cases,386 lesions were found and 341 lesions showed high uptake on both PET/MR and PET/CT.Among the remaining 45 PET-negative lesions,CT-positive and MR-negative contain 6 lesions,4 cases of which were from the lungs and 2 cases were from the vertebral body;MR-positive and CT-negative contain 9 lesions,including 4 livers,3 brains and 2 breasts.And there was no significant statistical difference(χ2=0.61,P>0.05)between detection efficiency of PET in PET/MR and PET in PET/CT.The PET-MR image had lower background uptake and higher SNR than the PET/CT image,with mean difference 1.9(95%CI:-2.8-6.6)and statistical difference(t=4.17,P<0.05).Bland-Altman analysis showed that the SUVmax of PET/MR showed was greater than that in PET/CT with significant difference(t=2.94,P<0.05)and mean difference 1.6(95%CI:-0.8-4.0),the two have good consistency(r=0.932).The average of T/B(PET/MR)was greater than that in PET/CT with significant difference(t=3.16,P<0.05)and mean difference 3.1(95%CI:-16.7-12.9).PET/MR shows better resolution of soft tissue organ than PET/CT,and PET/MR can more clearly show the internal structure of the tumor and its relationship with surrounding tissues;but PET/CT showed the lesion better than PET/MR in lung.The diagnostic results of the two devices had no statistical difference(χ2=1.04,P>0.05).Conclusion PET/MR and PET/CT showed the same lesion detection rate in children with tumors.PET images of PET/MR have higher signal-to-noise ratio(SNR)and better resolution,and PET/MR is more advantageous for the evaluation of lesions in the liver,brain and other soft tissue organs.
作者
梁江涛
许远帆
王芳晓
王佳
李成州
LIANG Jiangtao;XU Yuanfan;WANG Fangxiao(Zhejiang University of Traditional Chinese Medicine,Hangzhou,Zhejiang Province 310053,P.R.China)
出处
《临床放射学杂志》
CSCD
北大核心
2020年第3期600-604,共5页
Journal of Clinical Radiology
作者简介
通讯作者:李成州
