用铊-201单光子发射计算机断层扫描术对胶质瘤恶性程度进行术前分级：与传统计算机断层扫描的比较
Preoperative grading of glioma malignancy with thallium-201 single-photon emission CT: comparison with conventional CT.
作者信息
Källén K, Heiling M, Andersson A M, Brun A, Holtås S, Ryding E
机构信息
Department of Clinical Neurophysiology, University Hospital, Lund, Sweden.
出版信息
AJNR Am J Neuroradiol. 1996 May;17(5):925-32.
PURPOSE
To compare thallium-201 single-photon emission CT with conventional CT in grading the malignancy of gliomas and to determine the reliability of each in tumor assessment.
METHODS
We studied 37 patients who had gliomas (31 high grade and 6 low grade) and compared the CT findings with the thallium-201 index, which we defined as tumor uptake relative to the uptake in the contralateral hemisphere.
RESULTS
Among the high-grade gliomas, we observed a significant correlation between breakdown volume of the blood-brain barrier and thallium-201 uptake. However, 8 of the high-grade gliomas had low thallium-201 uptake, in the same range as the low-grade gliomas. Of these, 2 were nonenhancing and the other 6 showed ring enhancement on CT scans. Analysis of variance showed no significant difference in thallium-201 indexes between low-grade gliomas and highly malignant (grade II-III) gliomas. Accuracy of thallium-201 imaging was lower (78%) than that of CT (84%) in identifying high-grade gliomas.
CONCLUSIONS
Damage to the blood-brain barrier is a prerequisite for uptake of thallium-201 in gliomas. Tumors with central necrotic areas and moderate ring enhancement tend to be underestimated when evaluated by means of thallium-201 scintigraphy. The results indicate a need for caution when interpreting findings on images obtained with thallium-201 single-photon emission CT in preoperative evaluation of brain tumors.
目的
比较201铊单光子发射计算机断层扫描（SPECT）与传统CT在评估胶质瘤恶性程度方面的差异，并确定二者在肿瘤评估中的可靠性。
方法
我们研究了37例患有胶质瘤的患者（31例高级别胶质瘤和6例低级别胶质瘤），并将CT检查结果与201铊指数进行比较，我们将201铊指数定义为肿瘤摄取与对侧半球摄取的比值。
结果
在高级别胶质瘤中，我们观察到血脑屏障的破坏程度与201铊摄取之间存在显著相关性。然而，8例高级别胶质瘤的201铊摄取较低，与低级别胶质瘤处于同一范围。其中，2例无强化，另外6例在CT扫描上显示环形强化。方差分析显示低级别胶质瘤与高恶性（II - III级）胶质瘤之间的201铊指数无显著差异。在识别高级别胶质瘤方面，201铊成像的准确性（78%）低于CT（84%）。
结论
血脑屏障受损是胶质瘤摄取201铊的前提条件。通过201铊闪烁扫描评估时，具有中央坏死区和中度环形强化的肿瘤往往会被低估。结果表明，在术前评估脑肿瘤时，解读201铊单光子发射CT图像结果时需要谨慎。
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