氢质子二维化学位移成像波谱法评价脑胶质瘤的价值

Value of proton magnetic resonance spectroscopy with two-dimensional chemical-shift imaging in evaluating brain gliomas

目的探讨氢质子二维化学位移成像波谱技术在评价脑胶质瘤中的应用价值。方法脑胶质瘤36例,用二维化学位移成像氢质子波谱技术,SE序列行1H-MRS检查,波谱VOI包括肿瘤区、肿瘤周围水肿区或肿瘤周围无水肿区、对侧正常脑组织区,获得不同区域代谢物变化。结果低、高级别脑胶质瘤的肿瘤组织分别和对侧正常脑组织的NAA/Cr、Cho/Cr、NAA/Cho比值存在显著性差异(P<0.01);低级别脑胶质瘤和高级别脑胶质瘤的肿瘤组织的NAA/Cr、Cho/Cr、NAA/Cho比值存在显著性差异(P<0.05)。脑胶质瘤肿瘤组织和肿瘤周围水肿组织的NAA/Cr、Cho/Cr、NAA/Cho比值存在显著性差异(P<0.05);肿瘤周围水肿组织和对侧正常脑组织的NAA/Cr、Cho/Cr、NAA/Cho比值存在显著性差异(P<0.05)。脑胶质瘤肿瘤组织和肿瘤周围无水肿组织的NAA/Cr、Cho/Cr、NAA/Cho比值存在显著性差异(P<0.05);肿瘤周围无水肿组织和对侧正常脑组织的NAA/Cr、NAA/Cho比值存在显著性差异(P<0.05),但Cho/Cr比值无显著性差异(P>0.05)。结论二维化学位移成像波谱技术能为脑胶质瘤分级、瘤周侵犯情况及治疗提供准确有效的证据,且时间分辨率高。

Objective To study the value of proton magnetic resonance spectroscopy （^1H-MRS） with two-dimensional （2D） chemical-shift imaging （CSI） in evaluating brain gliomas. Methods Thirty-six patients with gliomas received examinations with 2D-CSI. The VOI of MRS included the tumor, peritumoral edematous and nonedematous areas, and the contralateral normal tissue. The changes of the metabolites in different areas were determined using 2D-CSI 1H-MRS with SE sequence and the metabolite ratios were calculated. Results Significant differences were found in the ratios of NAA/Cr, Cho/Cr and NAA/Cho between low-grade gliomas and contralateral normal brain tissue, and between high-grade gliomas and the contralateral normal tissue （P〈0.01）. The low-grade gliomas and high-grade gliomas differed significantly in the ratios of NAA/Cr, Cho/Cr and NAA/Cho （P〈0.05）. These ratios also showed significant differences between peritumoral edematous area and the glioma tissue, between the peritumoral edematous area and contralateral normal brain tissue （P〈0.05）, and between the peritumoral nonedematous area and the glioma tissue （P〈0.05）. Between the peritumoral nonedematous area and contralateral normal brain tissue, NAA/Cr and NAA/Cho ratios were significantly different （P〈0.05） but the Cho/Cr ratio was similar （P〉0.05）. Conclusion MRS with 2D-CSI can provide precise and effective evidences with high time resolution for glioma grading, assessment of peritumoral involvement and glioma therapies.