Shioya H, Mineura K, Sasajima T, Kowada M, Iida H, Ogawa T, Hatazawa J, Uemura K
Neurosurgical Service, Akita University Hospital, Japan.
No To Shinkei. 1994 Nov;46(11):1088-93.
We repeatedly measured kinetic rate constants and glucose metabolic rate (kinetic rCMRG1) using dynamic positron emission tomography (PET) and autoradiographic rCMRG1 in a patient with recurrent meningioma. A 50-year-old woman who presented with a left visual disturbance was admitted to our hospital. MR images revealed a mass lesion occupying the left middle fossa. The patient underwent Simpson grade IV surgery. The histological diagnosis was meningothelial meningioma. One year later the tumor had grown back to almost the same size as before treatment and was removed again by Simpson grade IV procedure. Postoperatively, the patient underwent radiation therapy (54 Gy). Two years after the second operation, the tumor was found to have invaded the left orbit and was resected by Simpson grade IV procedure. After additional radiation therapy, the patient was discharged. The rate constants were analyzed preoperatively and whenever the tumor recurred according to the three compartment 18F-fluorodeoxyglucose (FDG) model. Preoperative PET indicated tumor k1 and k2 values higher than in the contralateral gray matter, suggesting high permeability due to absence of the blood-tumor barrier and an abundant blood supply. The tumor k3 value, an indicator of hexokinase activity, was as high as in the contralateral gray matter. When the tumor recurred, the tumor k1, k2 and k3 values remained consistently high, indicating high proliferative activity. In contrast, the contralateral gray matter k1, k2 and k3 values decreased to some extent, suggesting effects of surgery or radiotherapy. Tumor rCMRG1 values, both autoradiographic and kinetic, were enhanced markedly.(ABSTRACT TRUNCATED AT 250 WORDS)
我们使用动态正电子发射断层扫描（PET）和放射自显影的葡萄糖代谢率（rCMRG1），对一名复发性脑膜瘤患者反复测量动力学速率常数和葡萄糖代谢率（动力学rCMRG1）。一名50岁出现左侧视觉障碍的女性入住我院。磁共振成像显示左中颅窝有占位性病变。该患者接受了辛普森四级手术。组织学诊断为脑膜内皮型脑膜瘤。一年后，肿瘤复发至几乎与治疗前相同大小，并再次通过辛普森四级手术切除。术后，患者接受了放射治疗（54 Gy）。第二次手术后两年，发现肿瘤侵犯左侧眼眶，并通过辛普森四级手术切除。在追加放射治疗后，患者出院。根据三室18F-氟脱氧葡萄糖（FDG）模型，在术前及肿瘤每次复发时分析速率常数。术前PET显示肿瘤的k1和k2值高于对侧灰质，提示由于血脑屏障缺失和血供丰富导致通透性高。肿瘤的k3值，即己糖激酶活性指标，与对侧灰质一样高。当肿瘤复发时，肿瘤的k1、k2和k3值持续保持高位，表明增殖活性高。相比之下，对侧灰质的k1、k2和k3值有所下降，提示手术或放疗的影响。肿瘤的放射自显影和动力学rCMRG1值均显著升高。（摘要截短于250字）
