脑肿瘤的^(31)PMRS特征

^(31)P MRS characteristics of cerebral tumors in vivo

目的比较不同脑肿瘤31PMRS的变化特征,探讨31PMRS在脑肿瘤中的临床应用价值。方法正常组36例,Ⅱ~Ⅲ级胶质瘤16例,成胶质细胞瘤12例,脑膜瘤16例。在1.5TMR机上完成波谱采集,jMRUI(1.3版)软件分析数据,计算体素内的pH值和各代谢物与β-ATP的相对浓度。结果正常组pH7.04±0.02,PCr/β-ATP1.51±0.03,PCr/Pi2.85±0.20,PDE/β-ATP2.70±0.40,PME/β-ATP1.01±0.03。Ⅱ~Ⅲ级胶质瘤组织碱性化,pH7.09±0.01,与正常组比较P<0.05;PCr/β-ATP(1.50±0.04)、PCr/Pi(2.49±0.21)、PME/β-ATP(1.04±0.07)与正常组比较无显著性差异;PDE/β-ATP(1.73±0.20)显著降低,P<0.05。成胶质细胞瘤组织碱性化,pH7.12±0.02,与正常组比较P<0.05;PCr/β-ATP(1.48±0.05)、PCr/Pi(2.39±0.23)与正常组比较无显著性差异;PDE/β-ATP(1.61±0.25)显著降低,P<0.05;PME/β-ATP(1.64±0.05)显著升高,P<0.05。脑膜瘤组织学特征是碱性化,pH7.16±0.03,与正常组比较P<0.005;PCr和PDE显著降低,PCr/β-ATP(0.46±0.04,P<0.001)、PCr/Pi(1.08±0.16,P<0.001)、PDE/β-ATP(0.82±0.10,P<0.001)显著降低,PME/β-ATP(2.05±0.03,P<0.005)显著升高。结论不同脑肿瘤在活体31PMRS上的变化具有特征性;31PMRS能无创性提供活体脑肿瘤pH值、能量状况及其磷脂代谢等方面的信息,有利于脑肿瘤的诊断与鉴别诊断。

Objective To analyze feature of various cerebral tumors on 31 p MRS and to explore the clinical application of 31PMRS in cerebral neoplasm. Methods The total subjects included control group （n= 36）, Ⅱ-Ⅲ grade gliomas （n= 16）, glioblastomas （n= 12） and meningiomas （n= 16）. All data were obtained by 1.5T MR scanner, the data were analyzed with jMRUI （1.3） software, and their pH value and semi quantitive metabolites divided by β-ATP were calculated. Results Control group： pH （7.04±0.02）, PCr/β-ATP （1.51±0. 03）, PCr/Pi （2.85±0.20）, PDE/β-ATP （2.70±0.40）, PME/β-ATP （1.01±0.03）. Ⅱ-Ⅲ grade gliomas： alkalosis （pH 7.09±0.01, P〈0.05）, PCr/β-ATP （1.50±0.04）, PCr/Pi （2.49 ± 0.21 ） ; To compare with control group, PDE/β-ATP （ 1.73 ± 0.20）, P〈0.05. Glioblastomas： far more alkalosis, pH 7.12±0.02, P〈0.05; PCr/β-ATP （1.48±0. 05）, PCr/Pi （2.39±0.23）, PDE/β-ATP （1.61±0.25）, P〈0.05, sig- nificantly decreased; PME/β-ATP （1.64±0.05, P〈0.05）, significantly increased. Meningiomas： obvious alkalosis, pH 7.16±0.03, P〈0. 005; PCr and PDE significantly decreased, PCr/β-ATP （0.46±0.04, P〈0. 001）; PCr/Pi （1.08± 0.16, P〈 0. 001） ; PDE/β-ATP significantly decreased, （0. 82 ± 0. 10, P〈 0. 001） ; PME/β-ATP increased significantly （2.05±0.03, P〈0. 005）. Conclusion Different cerebral neoplasms demonstrate characteristic change of ^31P MRS. ^31P MRS is capable of providing information about cerebral tumor pH, metabolism of energy and phospholipid. It is helpful for diagnosis and differential diagnosis of brain tumor.