PET/CT与PET/MR诊断恶性肿瘤的临床对照研究

doi:10.12117/jccmi.2018.09.013

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摘要目的：通过比较PET/CT与PET/MR所得最大标准化摄取值（Standardized uptake value，SUVmax）的差异性和相关性，探讨PET/MR一体机对恶性肿瘤病灶半定量分析的稳定性和准确性。方法：将中国医科大学附属盛京医院行全身PET/CT扫描的57例患者入组，（78±35）min后补扫全身PET/MR，所有病例均具有完整的临床或影像学资料，其中男22例，女35例，平均年龄（54±12）岁，扫描范围从颅顶至大腿根部，均采用GE公司的TOF-PET技术重建图像，结合融合图像在PET图像上勾画病灶和多处正常组织的ROI获得SUVmax，采用配对t检验分析两种技术SUVmax的差异性，Spearman相关分析分析其相关性。结果：PET/CT共检测出97个高代谢病灶，PET/MR共检测出100个高代谢病灶，两者共同检测出96个高代谢病灶。在依次进行PET/CT和PET/MR扫描的情况下，病灶的PET/MR SUVmax显著高于PET/CT SUVmax（P＜0.0001），大多数正常组织的PET/MR SUVmax显著低于PET/CT SUVmax（P均＜0.0001），只有腰大肌的PET/MR SUVmax略高于PET/CT SUVmax，但无统计学差异（P=0.056）；PET/MR所得病灶与正常组织的SUVmax比值均显著大于PET/CT（P＜0.0001）；所有病灶的SUVmax具有良好的相关性（r=0.92，P＜0.0001），所选取正常组织的SUVmax也具有良好的相关性（肺r=0.64；肝r=0.87；脾r=0.73；腰大肌r=0.57，P＜0.0001）。结论：肿瘤延迟PET/MR扫描所得的SUVmax较PET/CT明显升高，可能是由于PET/MR技术优势及恶性病灶自身延迟摄取葡萄糖所致。PET/MR与PET/CT的SUVmax高度相关，提示PET/MR一体机对恶性肿瘤病灶的半定量分析具有很好的稳定性和准确性。

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	孙洪赞1
	杜思瑶1
	辛军1
	陈忠维2

关键词 ：肿瘤, 各部位, 正电子发射断层显像术, 体层摄影术, 螺旋计算机, 磁共振成像

Abstract：Objective: The aim of this study was to demonstrate stability and accuracy in tumor semiquantitative assessment of the integrated PET/MR by analyzing difference and correlation between PET/CT SUVmax and PET/MR SUVmax. Methods: Fifty-seven patients(22 males, 35 females, average age (54±12) years), who underwent same day whole-body PET/CT and PET/MR in Shengjing Hospital Affiliated to China Medical University, the time interval between the two scans was (78±35) minutes. Patients underwent the whole-body PET/CT and PET/MR from the base of skull to upper thighs, TOF-PET technique of GE company was used to reconstruct images and SUVmax was obtained by fusion images to delineate ROI of lesions and some normal tissues. The difference analysis of SUVmax were performed with Paired t test and the correlation was analyzed with Spearman correlation analysis. Results: 97 hypermetabolism lesions were detected by PET/CT, 100 hypermetabolism lesions were detected by PET/MR, a total of 96 hypermetabolism lesions were detected by two modalities. The PET/MR SUVmax of lesions was significantly higher than that of PET/CT SUVmax(P<0.0001) in the case of PET/CT and following PET/MR. The PET/MR SUVmax of most normal tissues significantly lower than that of PET/CT(P<0.0001), only the PET/MR SUVmax of psoas was slightly higher than that of PET/CT, but there was no statistical difference(P=0.056). The ratios of PET/MR SUVmax of the lesion and the normal tissues were significantly higher than PET/CT(P<0.0001). There were significant correlations of SUVmax between PET/MR and PET/CT for lesions(r=0.92, P<0.0001) and for normal tissues(lung r=0.64;liver r=0.87; spleen r=0.73; psoas r=0.57, P<0.0001). Conclusions: The SUVmax of PET/MR in tumor was significantly higher than that of PET/CT, which may be due to PET/MR technical advantages and delayed glucose uptake by malignant lesions. PET/MR and PET/CT SUVmax highly correlated, suggesting that integrated PET/MR on semiquantitative analysis of malignant tumor lesions has a very good stability and accuracy.

Key words： Neoplasms by site Positron-emission tomography Tomography, spiral computed Magnetic resonance imaging

收稿日期: 2017-10-25

PACS:	Ｒ730.44
	Ｒ445.2
	Ｒ814.42
	Ｒ817.4

基金资助:国家自然科学基金青年基金（81401438）；辽宁省教育厅科学研究一般项目（L2014308）；辽宁省教育厅重点实验室基础研究项目（LZ2015079）。

通讯作者: 孙洪赞，中国医科大学附属盛京医院放射科，110004。E-mail：sunhz@sj-hospital.org

作者简介: 孙洪赞（1981-），男，辽宁东港人，副主任医师。E-mail：sunhz@sj-hospital.org

引用本文:

孙洪赞1，杜思瑶1，辛军1，陈忠维2. PET/CT与PET/MR诊断恶性肿瘤的临床对照研究[J]. 中国临床医学影像杂志, 2018, 29(9): 655-659.
SUN Hong-zan1, DU Si-yao1, XIN Jun1, CHEN Zhong-wei2. Comparison of whole-body PET/CT and PET/MR in clinical diagnosis of malignant tumors. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(9): 655-659.

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http://www.jccmi.com.cn/CN/10.12117/jccmi.2018.09.013 或 http://www.jccmi.com.cn/CN/Y2018/V29/I9/655

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