^1H-MRS在脑星形细胞瘤术前分级中的价值

The Value of Proton Magnetic Resonance Spectroscopy for the Grading of Astrocytoma

Objective:To discuss the value of 1H-MRS for the histological grading of astrocytoma before surgery,by using different quantitative patterns (relative quantitative pattern and standardization pattern).Methods:In 16 cases of grade Ⅰ～Ⅱand 20 cases of grade Ⅲ～Ⅳ astrocytoma proved by surgery and histology,the ratio of different metabolic material including Cho/Cr,Cho/NAA,NAA/Cr,Cho/Cho (n,contralateral normal-appearing white matter,CNWM) for the necrotic component,solid component of the tumor,peripheral area (1.0～2.0cm) of tumor,CNWM as well as the standardized value of NAA,Cho,Cr were calculated.Results:There was significant difference between Cho/Cr,Cho/NAA,NAA/Cr,NAA/S,Cho/S of solid component of tumor,peripheral area of tumor and CNWM,as well as between Cr/S of solid component and CNWM.Significant difference also existed between Cho/Cr,NAA/S of solid component and peripheral area as well as Cho/NAA,Cho/S of solid component for grade Ⅰ～Ⅱ and grade Ⅲ～Ⅳ astrocytoma.Lac and Lip can be depicted in astrocytoma by 1H-MRS.Conclusion:Spectroscopy finding of astrocytoma is different from that of normal brain tissue.Tumor can be identified by using 1H-MRS.Tumor grading of malignancy was correlated with Cho/Cr,NAA/S of solid component and peripheral area of tumor,as well as Cho/NAA,Cho/S of solid component.State of hypoxia can be assessed by Lac,and Lip was an assisted marker to assess the malignant grading of tumor.There were both advantages and disadvantages of the two 1H-MRS quantitative patterns used,combination of the two provides more reliable information for diagnosis.

Objective：To discuss the value of ^1 H-MRS for the histological grading of astrocytoma before surgery,by using different quantitative patterns （relative quantitative pattern and standardization pattern）. Methods： In 16 cases of grade I～Ⅱ and 20 cases of grade Ⅲ～Ⅳ astrocytoma proved by surgery and histology, the ratio of different metabolic material including Cho/Cr,Cho/NAA, NAA/Cr, Cho/Cho （n, contralateral normal-appearing white matter,CNWM） for the necrotic .component, solid component of the tumor, peripheral area （1.0～2.0cm） of tumor,CNWM as well as the standardized value of NAA, Cho, Cr were calculated. Results： There was significant difference between Cho/Cr, Cho/NAA, NAA/Cr, NAA/S, Cho/S of solid component of tumor,peripheral area of tumor and CNWM,as well as between Cr/S of solid component and CNWM. Significant difference also existed between Cho/Cr, NAA/S of solid component and peripheral area as well as Cho/ NAA,Cho/S of solid component for grade I～Ⅱ and grade Ⅲ～Ⅳ astrocytoma. Lac and Lip can be depicted in astrocytoma by ^1 H-MRS. Conclusion： Spectroscopy finding of astrocytoma is different from that of normal brain tissue. Tumor can be identified by using ^1 H-MRS. Tumor grading of malignancy was correlated with Cho/Cr, NAA/S of solid component and peripheral area of tumor,as well as Cho/NAA,Cho/S of solid component. State of hypoxia can be assessed by Lac, and Lip was an assisted marker to assess the malignant grading of tumor. There were both advantages and disadvantages of the two ^1 H-MRS quantitative patterns used, combination of the two provides more reliable information for diagnosis.