孤立性肺结节质子磁共振波谱的初步研究

Proton MR spectroscopy of solitary pulmonary nodules: a preliminary study

目的研究孤立性肺结节氢质子波谱(1H MRS)的特征及其代谢物变化规律,探讨MRS在孤立性肺结节鉴别诊断中的应用价值。方法应用SiemensVision1.5T超导磁共振机对69例孤立性肺结节行常规MRI检查和MRS测量,观察记录所有孤立性肺结节MR波谱特征及各代谢物参数值。10例手术标本行MRS检查,并将其结果与术前结节的MRS结果对照分析。结果恶性结节组患者胆碱含量(Cho)、胆碱与肌酸比值(Cho/Cr)及乳酸含量(Lac)明显高于炎性结节、结核球及错构瘤组(P<0.01,P<0.05,P<0.01)。10例手术标本MRS检测结果与术前MRS检测结果行配对t检验,两者之间无显著性差异。结论Cho升高、Cho/Cr值的增加和出现异常Lac峰是恶性结节的波谱特征,其对良恶性肺结节的鉴别诊断有重要的辅助诊断价值。

Objective:To study the metabolites of solitary pulmonary nodules and their proton MR spectroscopic characteristics so as to provide data for exploring the clinical value of MR spectroscopy in differentiating benign from malignant pulmonary nodules. Methods: Sixty-nine patients with solitary pulmonary nodules received routine MRI and single-voxel MR spectroscopy using Siemens Vision 1.5T MR system.MR spectroscopic characteristics and parameters of the metabolites were observed and recorded. Ten pathologic specimens were examined by single-voxel MR spectroscopic. The MR spectroscopic parameters of the pathologic specimens(10 from operation) were compared with those of the solitary pulmonary nodules in vivo. Results: The Cho peak,Cho/Cr and Lac peak of the malignant nodules were higher than those of the inflammatory tuberculous nodules and hamartoma^(P< ^0.01, P<0.05,P<0.01). There was no significant difference between the MR spectroscopic parameters of pathologic specimens and those of the solitary pulmonary nodules in vivo. Conclusion: The Cho peak, Cho/Cr and Lac peak of malignant nodules are higher than those of inflammatory tuberculous nodules and hamartoma. MR spectroscopy is helpful in differentiating benign from malignant pulmonary nodules.