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目的:观察并分析恶性脑胶质瘤术后患者放疗前、后99mTc-HL91 SPECT脑乏氧显像T/N比值的变化差异性及变化趋势,比较单纯术后放疗的Ⅱ级脑胶质细胞瘤患者放疗前后乏氧显像T/N比值差值与放疗后6个月疗效之间的相关性。方法:对35例恶性脑胶质瘤术后患者,分别于放疗前、后进行99mTc-HL91 SPECT脑乏氧显像检测,测定早期相(0.5小时)及延迟相(5个小时)的肿瘤区与周围正常脑组织放射性计数比值T/N,将检测结果进行差异性比较。筛选出其中13例Ⅱ级脑胶质瘤患者,以RECIST标准对比MRI资料评价放疗疗效,比较放疗前后T/N差值与疗效的相关性。结果:Ⅱ级脑胶质瘤术后患者乏氧显像早期相T/N比值均数值放疗后高于放疗前,差异有统计学意义(p<0.05)。Ⅱ级脑胶质瘤术后患者乏氧显像延迟相T/N比值均数值放疗后低于放疗前,差异有统计学意义(p<0.05)。Ⅲ级及Ⅱ-Ⅳ级脑胶质瘤术后患者乏氧显像延迟相T/N比值均数值放疗后低于放疗前,差异有统计学意义(p<0.05)。Ⅱ级脑胶质细胞瘤放疗前、后99mTc-HL91 SPECT脑乏氧显像延迟相(5小时)T/N比值差值与放疗后6个月疗效呈正相关,有统计学意义(r=0.635,p=0.020)。所有患者检测过程中均无任何严重毒副作用。结论:Ⅱ级恶性脑胶质瘤术后患者放疗前后99mTc-HL91 SPECT脑乏氧显像适用于短期放疗疗效的评价。
Objective: To observe and analyze the difference and trend of the T / N ratio of 99m Tc-HL91 SPECT before and after radiotherapy in patients with malignant glioma after radiotherapy. Compare the grade Ⅱ glial cells The correlation between the difference of T / N ratio of hypoxic imaging before and after radiotherapy and the curative effect at 6 months after radiotherapy. Methods: Thirty-five patients with malignant gliomas underwent 99mTc-HL91 SPECT before and after radiotherapy. The tumor area of early phase (0.5 hour) and delayed phase (5 hours) were determined. And the surrounding normal brain radioactive count ratio T / N, the test results were compared. Thirteen patients with grade Ⅱ gliomas were screened, and the radiotherapy effects were evaluated by RECIST standard contrast MRI data. The correlation between the T / N difference before and after radiotherapy and the curative effect were compared. Results: The T / N ratio of early stage of hypoxic imaging in grade Ⅱ glioma patients after radiotherapy was higher than that before radiotherapy, the difference was statistically significant (p <0.05). The T / N ratio of delayed phase of hypoxic imaging in grade Ⅱ glioma patients was lower than that of radiotherapy before radiotherapy (p <0.05). The T / N ratio of delayed phase of hypoxic imaging in grade Ⅲ and grade Ⅱ-Ⅳ glioma patients were lower than that of radiotherapy before radiotherapy (p <0.05). The difference of T / N ratio of 99mTc-HL91 SPECT brain hypoxic imaging before and after radiotherapy for grade Ⅱ glioma was positively correlated with the curative effect at 6 months after radiotherapy (r = 0.635 , p = 0.020). All patients tested without any serious side effects. Conclusion: The results of 99mTc-HL91 SPECT brain hypoxic imaging before and after radiotherapy for grade Ⅱ malignant glioma patients are suitable for the evaluation of the curative effect of short-term radiotherapy.