T2-FLAIR不匹配征象被认为是高度提示IDH突变星形胶质瘤的成像发现。本研究旨在确定T2-FLAIR不匹配征象与低级别胶质瘤中11C-甲硫氨酸摄取的相关性。我们在这项研究中纳入了78例经组织病理学证实的低级别胶质瘤（乙级：31例，丙级：47例）。78位患者在组织学诊断前进行了11C-甲硫氨酸正电子发射断层扫描（MET-PET）和磁共振（MR）成像扫描。通过将肿瘤最大标准摄取值（SUV）除以正常脑组织的平均SUV，计算了11C-甲硫氨酸摄取的肿瘤/正常比值（T/N）。通过三名独立评价者对MR成像扫描进行了T2-FLAIR不匹配征象的评估。我们比较了具有不同低级别胶质瘤分子类型的患者的分子状态、T2-FLAIR不匹配征象和11C-甲硫氨酸摄取情况。这78例低级别胶质瘤被分为三个分子组：A组（IDH突变和1p/19q非共删除，n = 22），O组（IDH突变和1p/19q共删除，n = 20）和W组（IDH野生型，n = 36）。T2-FLAIR不匹配征象在16例（20.5%）中被发现，其中分别有8例（36.4%）、0例（0%）、8例（22.2%）属于分子组A、O和W。具有T2-FLAIR不匹配征象的肿瘤的中位数MET-PET的T/N比值为1.50，明显低于没有T2-FLAIR不匹配征象的肿瘤（1.83，p < 0.001，Mann-Whitney U检验）。在A组和W组（排除O组）中，具有T2-FLAIR不匹配征象的肿瘤中，MET-PET的中位数T/N比值为1.50，明显低于没有T2-FLAIR不匹配征象的肿瘤（1.81，p = 0.002，Mann-Whitney U检验）。T2-FLAIR不匹配征象与低级别胶质瘤中11C-甲硫氨酸摄取量较低相关。© 2023. 该作者/作者，专有许可给Springer Science+Business Media, LLC，隶属于Springer Nature。

The T2-FLAIR mismatch sign is recognized as an imaging finding highly suggestive of IDH-mutant astrocytomas. This study was designed to determine whether the T2-FLAIR mismatch sign correlates with uptake of 11C-methionine in lower-grade gliomas.We included 78 histopathologically verified lower-grade gliomas (grade 2: 31 cases, grade 3: 47 cases) in this study. 78 patients underwent 11C-methionine positron emission tomography (MET-PET) scans and magnetic resonance (MR) imaging scans prior to histological diagnosis. The tumor-to-normal ratio (T/N) of 11C-methionine uptake was calculated by dividing the maximum standardized uptake value (SUV) for the tumor by the mean SUV of the normal brain. MR imaging scans were evaluated for the presence of the T2-FLAIR mismatch sign by three independent reviewers. We compared molecular status, the T2-FLAIR mismatch sign and 11C-methionine uptake among patients with different lower-grade glioma molecular types.The 78 lower-grade gliomas were assigned to one of three molecular groups: Group A (IDH-mutant and 1p/19q non-codeleted, n = 22), Group O (IDH-mutant and 1p/19q codeleted, n = 20), and Group W (IDH wildtype, n = 36). T2-FLAIR mismatch was found in 16 cases (20.5%) that were comprised of 8 (36.4%), 0 (0%), 8 (22.2%) cases in the molecular group A, O and W, respectively. The median T/N ratio of MET-PET in tumors with T2-FLAIR mismatch was 1.50, which was significantly lower than that of tumors without T2-FLAIR mismatch (1.83, p < 0.001, Mann-Whitney U test). In the Groups A and W (excluding Group O), the median T/N ratio on MET-PET in groups A and W (but not group O) with T2-FLAIR mismatch was 1.50, which was significantly lower than that of tumors without T2-FLAIR mismatch (1.81, p = 0.002, Mann-Whitney U test).The T2-FLAIR mismatch sign correlated with lower 11C-methionine uptake in lower grade gliomas.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.