Tomura Noriaki, Watanabe Osamu, Omachi Koichi, Sakuma Ikuo, Takahashi Satoshi, Otani Takahiro, Kidani Hiroyuki, Watarai Jiro
Department of Radiology, Akita University School of Medicine, 1-1-1 Hondo, Akita City, 010-8543 Akita, Japan.
Eur Radiol. 2004 Jul;14(7):1249-54. doi: 10.1007/s00330-003-2083-5. Epub 2003 Oct 3.
The aim of this study was to assess the value of fused MR and Tl-201 single photon emission computed tomography (SPECT) images in the diagnosis of recurrent head and neck tumors in patients after flap reconstruction surgery. Twenty-four patients after resection of primary head and neck tumors with flap reconstruction were suspected of having recurrent tumor by follow-up MR examination. Both MR examination and Tl-201 SPECT were prospectively performed to produce fused images. For qualitative analysis, two independent readers separately evaluated the existence of tumor recurrence in the fused images. The Tl-201 uptake of the lesion (Tl index) was also quantitatively compared with that of the normal nuchal muscles. Eighteen patients were histologically proved as having recurrence. The remaining 6 patients, false positive on MRI alone, had non-recurrence. Using the fused images, false positive was found in 1 case for one reader and 2 cases for the other reader. The Tl index of recurrent tumors was significantly higher (p < 0.001) than that of non-recurrent mass lesions. In the assessment of recurrent tumors following flap reconstruction surgery in the head and neck, the use of fused MRI and Tl-201 SPECT images can reduce the number of false positives.
本研究的目的是评估融合的磁共振成像（MR）和铊-201单光子发射计算机断层扫描（SPECT）图像在皮瓣重建手术后患者复发性头颈部肿瘤诊断中的价值。24例接受原发性头颈部肿瘤切除并皮瓣重建的患者经随访MR检查怀疑有肿瘤复发。前瞻性地进行了MR检查和铊-201 SPECT检查以生成融合图像。为进行定性分析，两名独立的阅片者分别评估融合图像中肿瘤复发的情况。还对病变的铊-201摄取（铊指数）与正常颈部肌肉的铊-201摄取进行了定量比较。18例患者经组织学证实有复发。其余6例仅MRI检查为假阳性的患者未复发。使用融合图像时，一名阅片者发现1例假阳性，另一名阅片者发现2例假阳性。复发性肿瘤的铊指数显著高于非复发性肿块病变（p<0.001）。在评估头颈部皮瓣重建手术后的复发性肿瘤时，使用融合的MRI和铊-201 SPECT图像可减少假阳性的数量。
