DWI检查在脑胶质瘤病理分级中的价值

Vaule of diffusion-weighted imaging in the pathiological grading of brain gliomas

目的探讨磁共振扩散加权成像(DWI)表观弥散系数(ADC)值和H1-磁共振波谱(H1-MRS)对脑胶质瘤病理分级的价值。方法对43例脑胶质瘤患者行DWI检查,分别测定肿瘤实质部分及对侧相应部位正常脑白质的ADC值及其比值(rADC);测定胶质瘤组织中代谢产物[N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)]水平及NAA/Cho、NAA/Cr、Cho/Cr值。将结果与术后病理行相关性分析。结果低级别胶质瘤(1～2级)ADC值和rADC值均明显高于高级别胶质瘤(3～4级),P均<0.01;二者均与肿瘤病理分级呈明显负相关(r分别为-0.767和-0.792,P均<0.01);高级别脑胶质瘤组织的NAA/Cho、NAA/Cr、Cho/Cr明显低于低级别者(P均<0.01);NAA/Cho、NAA/Cr值与病理级别呈负相关(r分别为-0.782和-0.712,P均<0.01);Cho/Cr值与病理级别呈正相关(r=0.806,P<0.01)。结论 ADC值和H1-MRS与胶质瘤的病理分级有明显相关性,可作为胶质瘤术前分级的依据。

Objective To investigate the value of apparent diffusion coefficient（ ADC） and H1-magnetic resonance spectrum（ H1-MRS） of diffusion-weighted imaging（ DWI） in the histologic grading of brain gliomas. Methods Forty-three patients with gliomas were performed with DWI examination ,the ADC values and relative ADC（ rADC） of different portions of gliomas and contralateral normal brain white matter were detected ; the metabolin of gliomas tissue[NAA,Cho,Cr]and NAA/Cho,NAA/Cr,Cho/Cr were measured. The correlation between the results and postoperative pathematology were analyzed. Results ADC values and rADC of solid portion of low grade （ grade 1 ～ 2） were higher than those of high grade （ grade 3 ～4） gliomas,P 0. 01; Both the ADC values and rADC were correlated negatively with pathiological grading of brain gliomas （ r were - 0. 767 and - 0. 792 respectively,P 0. 01） ; significant differences between high grade （ grade 3 ～ 4） and low grade gliomas （ grade 1 ～ 2） were found in the ratios of NAA/Cho,NAA/Cr and Cho/Cr（ P 0. 01） ; there was significantly negative correlation between the ratios of NAA/Cho,NAA/Cr and the pathiological grading of gliomas （ r were - 0. 782 and - 0. 712 respectively,P 0. 01） ; positive correlation was found in the ratios of Cho/Cr and the pathio-logical grading of gliomas （ r was 0. 806,P 0. 01） . Conclusions ADC values and H1-MRS of gliomas correlate well with pathiological grading of gliomas,can provide useful information in preoperative grading of gliomas.