18F-FDG PET/CT与MRT检测鼻咽癌颅底骨质浸润和靶区勾画的临床研究

摘要

Objective To evaluate the detective ability of magnetic resonance imaging (MRI) and positron emission tomography (PET) using 18-fluoro-2-deoxyglucose (FDG) PET/CT in skull base invasion in nasopharyngeal carcinoma.Methods 42 patients with nasopharyngeal carcinoma proved by pathology were examined by MRI and PET/CT which were performed at intervals ≤7 days.Results Of all the 42 patients,13 cases were positive in skull base invasion detected by MRI and PET/CT;6 cases were positive in MRI.but negative in PET/CT and 2 cases were positive only in PET/CT.There was no difference in two groups (P =0.289).The gross target volume delineated by PET/CT and by MRI (GTVP and GTVM) were compared.GTVP were smaller than their GTVM(P=0.0001).Conclusion The detection ability of PET/CT in skull base invasion in nasopharyngeal carcinoma is not superior to that of MRI.And because of false negative and leakage target,PET/CT can't replace MRI on delineation of target volume in nasopharyngeal carcinoma with skull base invasion.%目的 比较18 F-FDG PET/CT和MRI在鼻咽癌颅底骨质浸润中的诊断价值.方法 42例鼻咽癌患者行鼻咽部MRI检查,且于1周内行18F-FDG PET/CT全身扫描,比较二者对于颅底骨质浸润检测情况.结果 PET/CT与MRI诊断鼻咽癌颅底骨浸润均为阳性13例,单纯MRI诊断阳性6例,单纯PET/CT诊断阳性2例,两组比较,差异无统计学意义(P=0.289)；在颅底肿瘤靶区勾画方面,GTVP明显小于GTVM,两组比较,差异有统计学意义(P=0.0001).结论 18F-FDG PET/CT与MRI比较对鼻咽癌颅底骨浸润的检测无明显优势；在颅底骨质破坏靶区勾画中,由于假阴性和遗漏靶区可能,18F-FDG PET/CT还无法取代MRI.