PET脑血流量测量方法和临床应用进展

脑血流量测量对于脑血管疾病、脑肿瘤诊断和疗效评估具有重要的临床价值。PET是基于正电子示剂技术无创性、精确测量脑血流量的方法,正日益广泛地应用于临床。按照PET测量脑血流量的方法和使用的正电子示踪剂不同,其测量方法分为平衡法、放射自显影法和动力学方法三种。18O-H2O示踪剂PET测量脑血流量被认为测量脑血流方法的"金标准"。随着PET设备分辨率提高、新的图像重建方法使用和PET与MRI图像融合技术不断成熟,18F-FDG首次通过、采用图像衍生动脉输入函数(imagederived arterial input function,IDAIF)替代动脉抽血样精确测量脑血量方法受到广泛重视,有可能逐步取代高成本的18O-H2O测量脑血流量。PET无创、方便和精确测量脑血流量的方法在临床应使用有助于脑血管性疾病、脑肿瘤和脑退行性病变早期诊断、鉴别诊断和个性化医疗。本文介绍PET脑血流量测量原理、方法和临床应用进展。

Progress and Clinical Application of PET Cerebral Blood Flow MeasurementMethod

Cerebral blood flow measurement for cerebrovascular disease, brain tumor diagnosis and therapeutic effect evaluationhas important clinical value. PET is based on positron tracer technique for noninvasive, accurate measurement of cerebral blood flow isincreasingly widely used in clinical. PET measurement of cerebral blood flow in accordance with the methods and use of positron traceris different, and the measurement methods are divided into equilibrium method, autoradiographic method and dynamic method. 15O-H2Otracer PET measurement of cerebral blood flow is considered to be the "gold standard" method of cerebral blood flow measurement. Asthe PET equipment resolution improving, the new image reconstruction method using PET and MRI image fusion technology continuesto mature, the 18F-FDG first pass image using derivative arterial input function (IDAIF) replace artery blood sample accurate measurementof cerebral blood volume method has been paid attention to, may gradually replace the high cost of 15O-H2O measurement of cerebralblood flow. PET is noninvasive, convenient and accurate measurement of cerebral blood flow in clinical use will greatly promote cerebralvascular disease, brain tumor and brain degenerative disease early diagnosis, differential diagnosis and personalized medicine. This paperintroduced PET cerebral blood flow measurement principle, methods and progress in clinical application.