氢质子磁共振波谱在颅内肿瘤放疗效果评价中的应用研究

Proton MR spectroscopy evaluation of radiotherapy treated intracranial tumors

目的探讨颅内肿瘤放疗后采用氢质子磁共振波谱（^1HMRS）评价其疗效的临床应用价值。方法选择需行放疗的颅内肿瘤患者40例，在放疗前后分别观察和测量肿瘤和对侧正常组织的N-乙酰天冬氨酸（NAA）、胆碱（Cho）、肌酐（Cr）。计算肿瘤组织放疗前后的NAA／Cr、Cho／Cr、Cho／NAA的比值，并以Cho、Cho／NAA为观察指标，随访1年。结果颅内肿瘤放疗后，^1HMRS表现为Cho明显降低，NAA、Cr下降，Cho／Cr下降最明显，部分患者出现放射性坏死波。随访中有8例患者局部复发，^1HMRS表现为Cho、Cho／NAA再升高，未复发的患者^1HMRS未见明显异常。结论^1HMRS可评估颅内肿瘤放疗后的代谢变化，是一种判断其疗效的有价值的检查方法。

Objective To evaluate the clinical application of proton magnetic resonance spectroscopy（^1HMRS） in patients with radiotherapy treated intracranial tumors. Methods Forty patients with intracranial tumors who would need further radiotherapy after surgery underwent multivoxel ^1HMRS examination before and after radiotherapy. The concentration of N-acetylaspartate （ NAA ）, Choline （ Cho ）, Creatine （Cr） were obtained beth in the tumor and the contralateral normal brain region . The ratios of NAA/Cr、Cho/Cr、 Cho/NAA were calculated at the same time and 1-year follow-up. Results After radiotherapy, tumors which had been inhibited by radiation had decreased Cho、 NAA and Cr on ^1HMRS. Some lesions showed necrotic wave. During the 1-year follow-up, local recurrence was observed in 8 patients and their Cho,Cho/ NAA increased high again. In other patients ^1HMRS showed no change. Conclusions Multivoxel proton magnetic resonance spectroscopy which has become available for study of tumor metablites after radiotherapy, is valuable in the evaluation of radiotherapy treated tumors.