Davis W K, Boyko O B, Hoffman J M, Hanson M W, Schold S C, Burger P C, Friedman A H, Coleman R E
Department of Radiology, Duke University Medical Center, Durham, NC 27710.
AJNR Am J Neuroradiol. 1993 May-Jun;14(3):515-23.
To correlate the findings of gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA)-enhanced MR imaging with positron emission tomography (PET) in the evaluation of central nervous system neoplasia.
Thirty-six lesions identified on noncontrast MR in 35 patients with biopsy-proved intracranial tumors were imaged with both T1-weighted Gd-DTPA MR at 1.5 T and [18F]2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET). Eighteen women and 17 men with a mean age of 47.1 years (range 22-72) were studied. The degrees of Gd-DTPA enhancement and FDG uptake were rated separately, and then all scans were reviewed together. FDG uptake was graded 1-5.
Of the 35 lesions rated, 30 had Gd-DTPA enhancement and 28 of these were hypermetabolic (FDG accumulation greater than white matter) on PET (93% concordance). Twenty-six of 32 neoplastic lesions had Gd-DTPA enhancement. Twenty-four of these enhancing tumors were hypermetabolic. Only one lesion was completely missed on PET but identified on routine spin echo MR.
Gd-DTPA MR and FDG-PET are complementary and there is a high concordance of Gd-DTPA-enhancing tumours displaying FDG hypermetabolism. Although FDG hypermetabolism and Gd-DTPA enhancement are usually suggestive of high-grade malignancy, anaplastic astrocytomas may not enhance with Gd-DTPA and can be hypometabolic. In addition, benign intracranial tumors (two cases of meningioma) and radiation necrosis can be associated with both FDG uptake and Gd-DTPA enhancement.
在中枢神经系统肿瘤的评估中，将钆-二乙烯三胺五乙酸（Gd-DTPA）增强磁共振成像（MR）的结果与正电子发射断层扫描（PET）的结果进行关联。
对35例经活检证实患有颅内肿瘤的患者进行非增强MR检查，发现36个病灶，这些病灶均接受了1.5T的T1加权Gd-DTPA MR成像以及[18F]2-氟-2-脱氧葡萄糖（FDG）正电子发射断层扫描（PET）。研究对象包括18名女性和17名男性，平均年龄47.1岁（范围22-72岁）。分别对Gd-DTPA增强程度和FDG摄取程度进行评分，然后对所有扫描结果进行综合分析。FDG摄取分为1-5级。
在评估的35个病灶中，30个有Gd-DTPA增强，其中28个在PET上表现为高代谢（FDG积聚大于白质）（一致性为93%）。32个肿瘤性病灶中有26个有Gd-DTPA增强。这些强化肿瘤中有24个是高代谢的。PET仅漏诊1个病灶，但在常规自旋回波MR上可发现。
Gd-DTPA MR和FDG-PET具有互补性，Gd-DTPA强化的肿瘤显示FDG高代谢具有高度一致性。虽然FDG高代谢和Gd-DTPA增强通常提示高级别恶性肿瘤，但间变性星形细胞瘤可能不出现Gd-DTPA增强且可能为低代谢。此外，良性颅内肿瘤（2例脑膜瘤）和放射性坏死可能与FDG摄取及Gd-DTPA增强均有关。
