摘要
目的：为了评估99Tcm-HMPAO－SPECT影像在脑胶质瘤诊断中的意义。方法：72例经病理证实为胶质瘤的病人经作99Tcm-HMPAO单光子计算机断层扫描（SPECT）和核磁共振成像（MRI）检查。按WHO分类，其中包括33例低级别胶质瘤和39例高级别胶质瘤。使用肿瘤感兴趣区与小脑比值(TCI)半定量损害区99Tcm-HMPAO的摄取。MRI显示的肿瘤增强、坏死和水肿被分为三个等级；损害的99Tcm-HMPAO的摄取指数与其组织学级别和MRI特点的关系被分别评估。结果：在高级别胶质瘤组32.6％的损害显示了高的99Tcm-HMPAO吸收（TCI>1.0），55.8％为低吸收（TCI<0.8），仅11.6％显示了与正常脑组织近似的中度吸收（TCI：0.8~1.0）；在低级别胶质瘤组分别为10.3％，27.6％和62.1％，两组间TCI分布的差别是有意义的（P<0.01），同时肿瘤坏死和水肿对99Tcm-HMPAO吸收显示了有意义的影响。结论：与低级别胶质瘤相比，高级别胶质瘤的血流高低变化更为明显，肿瘤的坏死及水肿是导致局部血流降低的主要因素。
Abstract
Objective: To evaluate the significance of 99Tcm-HMPAO－SPECT in clinical evaluation of glioma. Methods: Seventy-two patients with primary glioma confirmed by pathology underwent 99Tcm-HMPAO and MRI. The uptake of 99Tcm-HMPAO was semi-quantified by tumor cerebellum index(TCI). In light of WHO classification system, these cases included 33 low-grade and 39 high-grade gliomas. Tumor MRI parameters i.e. enhancement, necrosis and edema were evaluated as three grades. Results: The relationships among 99Tcm-HMPAO uptake index and tumor histological grade and MRI characteristics were evaluated respectively. In the high-grade tumor group, 32.6% had a high uptake of 99Tcm-HMPAO(TCI>1.0). 55.8% low uptake(TCI<0.8), and 11.6% moderate uptake similar to normal brain tissue(TCI:0.8~1.0) In low-grade group, these ratios were 10.3%, 27.6% and 62.1% respectively. The difference between the two groups is significant. Both tumor necrosis and edema had a significant influrence on uptake of 99Tcm-HMPAO. Conclusions: The modification of rCBF in low-grade glioma is usually similar to normal brain tissue, but in high-grade lesion it is great. Tumor necrosis and edema are two factors in relation to low rCBF.
关键词
脑肿瘤 /
神经胶质瘤 /
体层摄影术 /
发射型计算机 /
单光子 /
磁共振成像
Key words
brain neoplasms /
glioma /
tomography /
emission-computed /
single-photon /
magnetic resonance imaging
郭宗泽;李光宇;李亚明.
99Tcm-HMPAO－SPECT功能影像在胶质瘤评估中意义的比较研究[J]. 中国临床医学影像杂志. 2007, 18(6): 408-410
GUO Zong-ze;LI Guang-yu;LI Ya-ming.
Significance of 99Tcm-HMPAO－SPECT in clinical evaluation of glioma[J]. Journal of China Clinic Medical Imaging. 2007, 18(6): 408-410
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