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PET/CT、头部增强CT和头部增强MRI对肺癌脑转移瘤检出价值的对比

夏露花 崇乐 马荣辉 董占飞 常诚 夏欢 郭浩 彭岩 王新华

夏露花, 崇乐, 马荣辉, 董占飞, 常诚, 夏欢, 郭浩, 彭岩, 王新华. PET/CT、头部增强CT和头部增强MRI对肺癌脑转移瘤检出价值的对比[J]. 分子影像学杂志, 2022, 45(1): 13-17. doi: 10.12122/j.issn.1674-4500.2022.01.03
引用本文: 夏露花, 崇乐, 马荣辉, 董占飞, 常诚, 夏欢, 郭浩, 彭岩, 王新华. PET/CT、头部增强CT和头部增强MRI对肺癌脑转移瘤检出价值的对比[J]. 分子影像学杂志, 2022, 45(1): 13-17. doi: 10.12122/j.issn.1674-4500.2022.01.03
XIA Luhua, CHONG Le, MA Ronghui, DONG Zhanfei, CHANG Cheng, XIA Huan, GUO Hao, PENG Yan, WANG Xinhua. Comparation on the value of PET/CT, head-enhanced CT and head-enhanced MRI in the detection of brain metastases from lung cancer[J]. Journal of Molecular Imaging, 2022, 45(1): 13-17. doi: 10.12122/j.issn.1674-4500.2022.01.03
Citation: XIA Luhua, CHONG Le, MA Ronghui, DONG Zhanfei, CHANG Cheng, XIA Huan, GUO Hao, PENG Yan, WANG Xinhua. Comparation on the value of PET/CT, head-enhanced CT and head-enhanced MRI in the detection of brain metastases from lung cancer[J]. Journal of Molecular Imaging, 2022, 45(1): 13-17. doi: 10.12122/j.issn.1674-4500.2022.01.03

PET/CT、头部增强CT和头部增强MRI对肺癌脑转移瘤检出价值的对比

doi: 10.12122/j.issn.1674-4500.2022.01.03
基金项目: 

新疆维吾尔自治区自然科学基金 2017D01C411

详细信息
    作者简介:

    夏露花,博士,主治医师,E-mail: xialuhuahua@163.com

    通讯作者:

    王新华,主任医师,副教授,硕士生导师,E-mail: xj1w@sina.com

Comparation on the value of PET/CT, head-enhanced CT and head-enhanced MRI in the detection of brain metastases from lung cancer

  • 摘要:   目的  分析与探讨18F-FDG PET/CT+头部增强CT、18F-FDG PET/CT+头部增强MRI几种检查方法对肺癌脑转移瘤的诊断价值与差异。  方法  回顾分析327例肺癌患者的临床资料,对比其18F-FDG PET/CT、头部增强CT及头部增强MRI影像资料,分析18F-FDG PET/CT联合头部增强CT、18F-FDG PET/CT联合头部增强MRI对肺癌分期的影响;比较18F-FDG PET/CT、头部增强CT、头部增强MRI 3种检查方法对肺癌脑转移瘤检出价值;比较18F-FDG PET/CT与头部增强MRI,肺癌脑转移瘤漏诊组与未漏诊组囊变、水肿表现的差异。  结果  18F-FDG PET/CT+头部增强CT、18F-FDG PET/CT+头部增强MRI这两种组合检查方法在检出肺癌脑转移瘤方面,对肺癌分期的影响差异有统计学意义(χ2=305.58,P < 0.01);18F-FDG PET/CT、头部增强CT、头部增强MRI三种检查方法对肺癌脑转移瘤检出率分别为7.34%、12.23%、19.88%;3种检查方法对肺癌脑转移瘤检出情况比较差异具有统计学意义(χ2=22.867,P < 0.01);肺癌脑转移瘤18F-FDG PET/CT与MRI比较漏诊组与未漏诊组发生囊变、水肿情况的差异无统计学意义(χ2=0.657,P > 0.05;χ2=0.023,P > 0.05);漏诊组、未漏诊组出现囊变率为31.70%(13/41)、41.67%(10/24);漏诊组、未漏诊组出现水肿率为56.09%(23/41)、54.17%(13/24)。  结论  18F-FDG PET/CT+头部增强CT、18F-FDG PET/CT+头部增强MRI检查均能够提高肺癌脑转移瘤的检出率,对精确判断肺癌分期,掌握脑转移瘤详细情况,降低脑转移瘤的漏诊率有重要作用,检出价值最高的是18F-FDG PET/CT+头部增强MRI联合。

     

  • 图  1  肺癌患者脑转移瘤头部平扫CT图像(A)、头部PET/CT图像(B~C)及头部增强MRI(D)图像

    A: 头部平扫CT图像,右侧枕叶片状低密度影, 无法清楚显示脑转移瘤; B~C: PET/CT图像,右侧枕叶片状低密度影, 放射性分布略减低, 无法显示脑转移瘤; D: 增强MRI图像清晰显示右侧枕叶脑转移瘤, 边缘强化, 低密度影为周围水肿带.

    Figure  1.  The plain CT imaging of the head, PET/CT imaging and enhanced MRI imaging of a patient.

    表  1  肺癌患者性别与具体病理类型资料

    Table  1.   Data of gender and specific pathological types of lung cancer patients (n)

    性别 鳞癌 腺癌 腺鳞癌 淋巴上皮瘤样癌 神经内分泌癌 分化差的癌
    男(n=216) 58 153 3 0 2 0
    女(n=111) 10 93 2 4 1 1
    下载: 导出CSV

    表  2  肺癌患者分期及病理类型

    Table  2.   Data of lung cancer patients stage and pathological type (n)

    分期 非小细胞癌 小细胞癌
    Ⅰ期(n=51) 51 0
    Ⅱ期(n=30) 30 0
    Ⅲ期(n=85) 82 3
    Ⅳ期(n=161) 160 1
    总计(n=327) 323 4
    下载: 导出CSV

    表  3  肺癌患者分期及具体病理情况

    Table  3.   Data of lung cancer patients stage and specific pathological (n)

    分期 鳞癌 腺癌 腺鳞癌 淋巴上皮瘤样癌 神经内分泌癌 分化差的癌
    Ⅰ期(n=51) 5 46 0 0 0 0
    Ⅱ期(n=30) 12 17 0 1 0 0
    Ⅲ期(n=85) 36 43 2 1 3 0
    Ⅳ期(n=161) 15 140 3 2 0 1
    总计(n=327) 68 246 5 4 3 1
    下载: 导出CSV

    表  4  PET/CT+头部增强CT及PET/CT+头部增强MRI联合组两组肺癌分期改变情况

    Table  4.   Changes of lung cancer stage in PET/CT+head enhanced CT and PET/CT+head enhanced MRI combined groups (n)

    检查方法比较 临床分期
    改变 不改变 总计
    PET/CT+头部增强CT联合 1 326 327
    PET/CT+与头部增强MRI联合 7 320 327
    χ2 305.58
    P < 0.01
    下载: 导出CSV

    表  5  三种检查方法肺癌脑转移瘤检出率比较

    Table  5.   Comparison of the detection rates of lung cancer brain metastases by the three methods (n=327)

    检查方法 检出有脑转移病瘤(n) 检出率(%)
    PET/CT 24 7.34
    头部增强CT 40 12.23
    头颅增强MRI 65 19.88
    下载: 导出CSV

    表  6  三种检查方法对肺癌脑转移瘤检出情况比较

    Table  6.   Comparison of three examination methods in the detection of lung cancer brain metastasis (n, n=327)

    检查方法 检出脑转移病瘤
    (+) (-)
    PET/CT 24 303
    头部增强CT 40 287
    头部增强MRI 65 262
    χ2 22.867
    P < 0.01
    下载: 导出CSV

    表  7  肺癌脑转移瘤PET/CT与MRI比较漏诊组与未漏诊组囊变情况

    Table  7.   Comparison between PET/CT and MRI of brain metastases of lung cancer and missed diagnosis group (n)

    组别 囊变 无囊变
    漏诊组(n=41) 13 28
    未漏诊组(n=24) 10 14
    χ2 0.657
    P > 0.05
    下载: 导出CSV

    表  8  肺癌脑转移瘤PET/CT与MRI比较漏诊组与未漏诊组水肿情况

    Table  8.   Comparison between PET/CT and MRI of brain metastases of lung cancer and missed diagnosis group (n)

    组别 水肿 无水肿
    漏诊组(n=41) 23 18
    未漏诊组(n=24) 13 11
    χ2 0.023
    P > 0.05
    下载: 导出CSV
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  • 收稿日期:  2021-10-26
  • 网络出版日期:  2022-03-29
  • 刊出日期:  2022-01-20

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