多体素1H磁共振波谱在脑胶质瘤诊断及分级中的应用研究

Evaluation of 3.0T 1H-MR spectroscopy imaging in the diagnosis and grading of gliomas

目的探讨多体素1H磁共振波谱在脑胶质瘤诊断及分级中的价值。方法选取经手术病理或临床确诊的36例脑胶质瘤患者。采用美国GE公司SignaEXCITEHD3．0T超导型磁共振（MR）扫描仪对所有患者行颅脑常规核磁共振（MRI）扫描和二维多体素144ms序列扫描。采用Functool软件包后处理，分别测定病变实质、病变周围及健侧相应区域的胆碱（Cho）／肌酸（Cr）、Cho／N-乙酰天门冬氨酸（NAA）、NAA／Cr比值及肌醇（MI）值的变化，并对结果进行统计学分析。结果全组数据采用SAS8．2软件处理，结果显示：低级别胶质瘤和高级别胶质瘤瘤体区Cho／Cr、Cho／NAA、NAA／Cr比值及MI值分别比较差异有统计学意义（P〈0．05）；瘤周水肿区Cho／Cr、NAA／Cr比值分别比较差异有统计学意义（P〈0．05），MI值比较差异无统计学意义（P〉0．05）。结论，H—MRS在鉴别诊断脑胶质瘤中有重要价值，结合MR其他成像方法可对其做出较为准确的分级。

Objective To investigate the value in MR spectrum of diagnosis and grading of gliomas. Methods 36 cases of patient with gliomas who confirmed by histopathologic findings or clinical follow-up were collected. Using a GE Signa EXCITE HD 3.0T super conduct MR unit, all the cases of patients were performed conventional MR scan and multi-voxel with 2-D muhi-voxel PRESS 144 ins. Functool software was used for post-processing of spectrum. The ratios of NAA/Cr, NAA/Cho, Cho/Cr were measured in the solid part of masses, eireum of tumors and contralateral parenchyma respectively. The result was processed by the statistical method. Results The statistical analysis was exacted by SAS 8.2 software. In the solid part of masses, there were significant differences between low-grade gliomas and high-grade gliomas in the ratios of Cho/Cr, Cho/NAA,NAA/Cr and M1 （P 〈0.05）, but in peritumoral edema, there were significant differences in the ratios of Cho/Cr, NAA/Cr （P 〈0.05）, and no significant differences in the ratios of MI （P 〈0.05）. Conclusion 1H-MRS is very important and useful in the evaluation of gliomas. It has made it possible to exactly evaluate the grade of gliomas combined with other imagings.