摘要
目的研究颅脑肿瘤的磁共振质子波谱(1H-MRS)的表现及其临床诊断与鉴别诊断价值。方法50例行1H-MRS检查的不同组织类型来源颅脑肿瘤患者,术后均经病理明确诊断,观察和测量肿瘤和对侧正常组织的N-乙酰天冬氨酸(NAA)、肌酸(Cr)、复合胆碱(Cho)、乳酸(Lac)、脂质(Lip)峰值,计算肿瘤NAA/Cr、Cho/Cr、NAA/Cho以及肿瘤NAA/正常NAA、肿瘤Cho/正常Cho、肿瘤Cr/正常Cr的比率。结果颅脑肿瘤Cr下降,Cho升高,但不同组织类型肿瘤的Cr、Cho变化无显著差异。脑肿瘤NAA下降明显,其中不同组织类型中脑膜瘤、胶质瘤相比变化无显著差异,但均明显低于听神经瘤和转移瘤(P<0.05)。胶质瘤的NAA/Cr明显低于转移瘤和听神经瘤,P值分别为0.015、0.028。各肿瘤的Cho/Cr无显著差异。结论1H-MRS是研究肿瘤代谢的有效方法,肿瘤NAA/正常NAA、NAA/Cr有助于颅脑肿瘤的诊断和鉴别诊断。
Objective To investigate the multivoxel proton MR spectroscopy findings of brain tumors and the clinical significance in differential diagnosis. Methods Sixty patients with brain tumors underwent multivoxel proton MR spectroscopic examination with PRESS sequence. Distri-bution of the 50 final diagnoses of neoplasms was as follow:meningioma(n=20) ,glioma(n=23), metastasis(n = 4), acoustic neuroma(n = 3). The concentrations of NAA, Cho, Cr, and Lac-Lip were obtained in the tumors and the contralateral normal brain region. The ratios of NAA/Cr, Cho/Cr,NAA/Cho. tumor NAA/normal NAA, tumor Cho/normal Cho, tumor Cr/normal Cr were calculated. Results ^1H-MRS showed decreased NAA,Cr and elevated Cho. NAA concentrations in meningioma, glioma, decreased significantly to acoustic neuroma,metastasis, but Cho in tumors changed without significance. NA .A/Cr ratio was significantly lower in glioma than that in acoustic neuroma and metastasis,and P value was 0. 015,0. 028,respectively: No significance was found in tumor Cho/Cr data. Conclusion Multivoxel ^1H-MRS is available for study of tumor metabolites. The tumor NAA/normal NAA,NAA/Cr were helpful for the diagnosis and differential diagnosis of intracranial tumors.
出处
《实用临床医学(江西)》
CAS
2008年第5期98-101,共4页
Practical Clinical Medicine