Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN.
Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN.
Semin Ultrasound CT MR. 2020 Dec;41(6):541-550. doi: 10.1053/j.sult.2020.08.008. Epub 2020 Aug 29.
Several non-neoplastic processes, including infection, inflammation, demyelination, vasculitis, autoimmune disease, and post-treatment changes (radiation therapy or chemoradiation) can result in a mass-like, space-occupying lesion on conventional computed tomography (CT) or magnetic resonance (MR) imaging of the brain. Additionally, non-neoplastic processes can produce imaging findings that mimic nontumoral neoplastic involvement of the central nervous system. Such instances pose a substantial diagnostic dilemma for interpreting radiologists, as well as clinicians tasked with determining the appropriate diagnostic tests and therapeutic strategies for these patients. Nuclear medicine studies, including single positron emission computed tomography (SPECT) and positron emission tomography (PET), as well as hybrid SPECT/CT, PET/CT, and PET/MRI may offer important diagnostic insights into these challenging cases, often helping to differentiate these mimics from true brain neoplasms. In this review, we detail common and uncommon brain tumor mimics in specific context of PET and SPECT imaging of the brain, including the multimodality imaging appearance of tumor mimics and the potential roles these modalities may play in providing diagnostic clarity.
多种非肿瘤性病变,包括感染、炎症、脱髓鞘、血管炎、自身免疫性疾病和治疗后改变(放射治疗或放化疗),可导致脑的常规计算机断层扫描(CT)或磁共振成像(MR)出现肿块样占位性病变。此外,非肿瘤性病变可产生类似中枢神经系统非肿瘤性肿瘤累及的影像学表现。这些情况给解释影像的放射科医生以及负责为这些患者确定适当诊断测试和治疗策略的临床医生带来了重大的诊断难题。核医学研究,包括单光子发射计算机断层扫描(SPECT)和正电子发射断层扫描(PET),以及 SPECT/CT、PET/CT 和 PET/MRI 融合,可为这些具有挑战性的病例提供重要的诊断见解,通常有助于将这些模拟物与真正的脑肿瘤区分开来。在这篇综述中,我们详细介绍了脑的 PET 和 SPECT 成像中常见和不常见的脑瘤模拟物,包括肿瘤模拟物的多模态成像表现以及这些模态在提供诊断清晰度方面可能发挥的作用。