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烟雾病（moyamoya disease,MMD)是一种起因不明的慢性进行性脑血管疾病，可导致脑出血或脑缺血事件发生。因此，准确评估MMD患者脑血流灌注情况对选择合适的治疗方式和判断预后尤为重要，⁹⁹Tc^m,-双半胱乙酯 (⁹⁹Tc^m-ECD)单光子发射计算机断层成像术（SPECT)-CT可提供脑血流灌注信息，具有较好的临床应用价值。本研究应用NeuroGam软件对MMD患者手术前后脑血流灌注情况进行定性和定量分析，评估手术疗效。

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Abstract To evaluate the clinical value of NeuroGam software in assessing the brain focl perfusion changes by 99mTc-ECD single photon emission computed tomography/computed tomography (SPECT/CT) brain imaging in patients with Moyamoya Disease(MMD). Seventy-two patients with MMD who underwent superficial temporal artery-middle cerebral artery (STA-MCA) bypass combined with encephalo-duro-myo-synangiosis (EDMS) surgical revascularization were included. Baseline and follow-up omTc-ECD SPECT/CT brain scans were performed on all patients at least twice before and after operation. Pre-and post-SPECT dicom images were reoriented into Talairach space using NeuroGam Software package, Additional visual analysis was performed. Differences mean pixel value between pre-and post-operation brain perfusion were assessed with paired t test and McNemar test. Significant differences in the number of hypoperfusion focl were found between visual assessment and NeuroGam aided assessment. More hypoperfusion focl were found by NeuroGam software aided assessment in the fronta, parietal, temporal,becipital lobe , thalamus , basal ganglia and cerebellum before and after surgery ( P < . 0001 ) . According to NeuroGam software assessment, the perfusion of frontal, parietal, temporal lobe, anterior and middle cerebral regions on the operative side significantly improved before and after surgery (t=-3.734,t=-3.935,t=-5.099,t=-4.006,t=-5.170, all P&lt;.001). However, no significan differences were found in the occipital lobe (t=-1.962. P=.054), thalamus (t = 1.362. P=. 177), basal ganglia(t-2.394, P=.019)and cerebellum (t=1.383.P=.171)before and after surgery. The NeuroGam software provides a quantitative approach for monitoring surgical effect of MMD in a variable time (3-12 months after surgery). It could discover the perfusion changes that are neglected in convertional visual assessment.

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目的：探讨运用纹理分析方法分析PET/CT和多参数磁共振成像(magnetic resonance imaging,MRI)图像检出移行带前列腺癌的价值。

方法：分析36例移行带前列腺癌患者的18F-FDG PET/CT图像和T1WI、T2WI和扩散加权成像（diffusion-weighted imaging,DWI)图像肿瘤区域和非肿瘤区域的图像纹理。运用检验或非参数Mann-WhitneyU检验比较上述区域图像纹理特征的差异；用受试者工作特征（receiver operating characteristic,ROC)曲线分析方法分别评价各参数检出移行带前列腺癌的效率，用曲线下面积（area under curve,AUC)表示。

结果：肿瘤区PET/CT和DW图像的均值（分别为167.5±17.1和76.8±18.3)高于非肿瘤区（分别为115.3±15.8和54.6±10.8),差异均有统计学意义（P均<0.001);肿瘤区T1W图像偏度（0.166±0.447)大于非肿瘤区[-(0.188±0.433),P=0.030]。联合上述3项指标，检出肿瘤的灵敏度为100.0%,特异度为93.7%,AUC为0.992(95%C1:0.972~1.000)。

结论：基于PET/CT和多参数MR图像纹理分析可为移行带前列腺癌的有效检出提供可靠的客观依据。