脑星形细胞瘤水肿区质子磁共振波谱研究

Study of 1H-magnetic resonance spectroscopy in the peritumoral edema of astrocytomas in brain

目的探讨质子磁共振波谱(1H-MRS)在检测星形细胞瘤水肿区代谢物变化规律与病理分级中的应用价值。方法选择经病理证实的36例脑星形细胞瘤患者,分为低级别星形细胞瘤(LGA)组12例、间变性星形细胞瘤(AA)组11例和胶质母细胞瘤(GBM)组13例。每位患者术前均行常规扫描和增强扫描,随后行多体素1H-MRS检查,检测肿瘤水肿区N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)和乳酸(Lac)代谢物浓度,比较3组间肿瘤水肿区NAA/Cr、Cho/Cr及NAA/Cho比值平均值变化情况。结果水肿区Cho/Cr比值在LGA组与AA组、GBM组之间差异均有统计学意义(P<0.05),且恶性程度越高Cho/Cr比值越高。结论1H-MRS可提高对脑星形细胞瘤分级诊断的准确性,并有助于制定手术方案。

Objective To study the clinical value of ^1H--magnetic resonance spectroscopy （^H-MRS） in determining the level of metabolites and grading astrocytoma. Methods Twenty-six cases with astrocytomain brain （ 12 patients with low-grade astrocytroma, 11 patients with anaplastic astrocytoma, 13 patients with glioblastoma multiform） comfinned by patgologic diagnosis, were underwent routine MRI, enhanced MRI and IH-MRS. The level of the metabolites including N-acetylaspartate （NAA）, choline （Cho）, and creatine （Cr） and lactate （LaC） were measured in the regions of edema. The ratios of NAA/Cr, NAA/Cho, and Cho/Cr were also computed. Results The ratios of Cho/Cr were significantly different among the three groups, and the ratios of Cho/Cr were correlated with the grade malignancy of the astrocytoma. Conclusion 1H-MRS can improve the accuracy of diagnosis and histopathologic grade of the astrocytoma, which may be useful for the design of the operation plan.