多体素~1H-MRS在脑胶质瘤术前评价中的应用

Clinical application of multivoxel ~1H-MRS in preoperative evaluation of cerebral gliomas

目的运用多体素二维磁共振波谱法（H-MRS）分析脑胶质瘤周围区域。H-MRS代谢物改变特点，评价H-MRS在脑胶质瘤术前的应用价值。方法收集经手术及病理证实的28例胶质瘤患者，所有患者在术前均行磁共振头颅常规检查和。H-MRS检查。分别测量不同区域的N-乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho）峰下面积，计算出NAA／Cr、Cho／Cr及NAA／Cho比值，并进行统计学分析。结果低／高级别胶质瘤肿瘤组织和对侧正常脑组织的NAA／Cr、Cho／Cr及NAA／Cho比值存在显著性差异；低／高级别胶质瘤肿瘤组织和远瘤周区域的NAA／Cr、Cho／Cr及NAA／Cho比值存在显著性差异；低级别胶质瘤远瘤周区域和对侧正常脑组织的NAA／Cho比值存在显著性差异，NAA／Cr、Cho／Cr比值不存在显著性差异；高级别胶质瘤远瘤周区域和对侧正常脑组织的Cho／Cr、NAA／Cho比值存在显著性差异，但NAA／Cr比值不存在显著性差异。结论多体素H-MRS可帮助临床医生在术前评价胶质瘤的浸润范围，并制定最佳的治疗方案。

Objective To analyze the metabolic characteristics and the changes by 2D muhivoxel proton magnetic resonance spectroscopy （H-MRS） and to evaluate application valne of H-MRS in the preoperation of gliomas. Methods 28 patients confirmed by pathology were performed by Routine MR and H-MRS. NAA, Cr and Cho peak area were detected in different areas, NAA/Cr, Cho/Cr and NAA/Cho ratio were calculated and analyzed statistically. Results Significant differences between low/high grade gliomas and normal brain tissues were found in the ratios of NAA/Cr, Cho/Cr and NAA/Cho. Significant differences between low/high grade gliomas and the far side peritumoral brain tissues were found in the ratios of NAA/Cr, Cho/Cr and NAA/ Cho. Significant differences between the far side peritumoral brain tissues of low grade gliomas and normal brain tissues were found in the ratios of NAA/Cho, but there were no significant differences in the ratios of NAA/Cr and Cho/Cr. Significant differences between the far side peritumoral brain tissues of high grade gliomas and normal brain tissues were found in the ratios of NAA/Cho and Cho/Cr, but there were no significant differences in the ratios of NAA/Cr. Conclusion H-MRS may be helpful to defining the border of brain glioma and designing the best the therapeutic protocols.