增强后多体素^1H-MRS对脑胶质瘤、单发转移瘤和脑脓肿的鉴别诊断价值

Value of post-contrast multivoxel ^1H-MRS in the differential diagnosis of cerebral gliomas, solitary metastase and abscess

目的:探讨注射对比剂后多体素1H-MRS对脑胶质瘤、单发转移瘤和脑脓肿的鉴别诊断价值。方法:搜集脑胶质瘤16例、单发转移瘤19例和脑脓肿6例,均行注射对比剂后多体素1H-MRS检查。10例年龄匹配的健康志愿者作对比。比较脑胶质瘤与单发转移瘤强化区及强化边缘区胆碱/肌酸(Cho/Cr)、氮-乙酰天门冬氨酸/胆碱(NAA/Cho)、氮-乙酰天门冬氨酸/对侧相应正常脑组织区胆碱(NAA/Cho-n)和胆碱/对侧相应正常脑组织区胆碱(rCho)值的差异,并做统计学分析。结果:各个级别胶质瘤与单发转移瘤强化区之间Cho/Cr值分别为3.1709±2.197和4.3520±2.509,NAA/Cho-n值分别为0.3312±0.301和0.3843±0.223,差异均无统计学意义(P>0.05);而NAA/Cho值分别为0.2436±0.220和0.4550±0.240,rCho值分别为1.5426±0.808和0.9129±0.304,差异均有统计学意义(P<0.05);强化边缘区之间上述比值分别为Cho/Cr1.6208±0.230和0.9105±0.414,NAA/Cho-n0.5357±0.250和0.8015±0.374,NAA/Cho0.4762±0.278和2.4434±1.636,rCho1.1761±0.423和0.5405±0.497,除NAA/Cho-n外差异均有显著统计学意义(P<0.001)。脑脓肿出现特征性波谱。结论:增强后多体素1H-MRS对脑胶质瘤、单发转移瘤和脑脓肿的鉴别诊断有重要的临床应用价值。

Objective：To explore tge value of post contrast multivoxel ^1H-MRS in the differential diagnosis of cerebral glioma, solitary metastases and abscess. Methods： 16 cases of cerebral glioma, 19 cases of solitary metastase, and 6 cases of abscess were collected. All cases were performed post-contrast MR spectroscopy successfully. Ten age-matched healthy volunteers underwent post-contrast ^1H-MR spectroscopy for comparison. The Cho/Cr, NAA/Clio, NAA/Cho-n, rCho value of enhancing region and peritumoral region were compared respectively between glioma and solitary metastases. The results were analyzed statistically. Results： The Clio/Cr of glioma and metastases was 3.1709 ± 2.197 and 4.3520 ± 2.509 respectively; the NAA/Cho-n was 0. 3312 ± 0. 301 and 0. 3843 ±0. 223 respectively. No significant differences were found for all ratios mentioned above between the two groups （ P 〉 0.05）. The NAA/Cho was 0.2436 ± 0.220 and 0. 4550 ± 0. 240 respectively, the rCho was 1. 5426 ± 0. 808 and 0. 9129 ±0. 304 respectively. All ratios had significant differences （ P 〈 0.05 ）. The Cho/Cr in peritumoral regions of the two groups was Cho/Cr 1. 6208 ± 0. 230 and 0.9105± 0.414 respectively,the NAA/Cho-n was 0.5357 ±0.250 and 0.8015 ± 0.374 respectively, the NAA/Cho was 0.4762 ± 0.278 and 2.4434 ± 1.636 respectively,the rCho was 1. 1761 ±0.423 and 0.5405 ± 0.497 respeetively. All ratios had significant differences （ P 〈 0.001） except NAA/Cho-n （ P 〈 0.05）. There was eharaeteristic spectroscopy in cerebral abscess. Conclusion： Post-contrast multivoxel ^1 H-MRS plays an important role in the differential diagnosis of cerebral glioma, solitary metastases and abscess.