1H-MRS在鉴别单发脑囊变胶质瘤与转移瘤中的价值

Values of ~1H-MRS in the Differential Diagnosis in Cystic Matastatic Encephaloma and Glioma

目的探讨1H-MRS对囊变脑胶质瘤与囊变转移瘤的鉴别诊断价值大小。材料与方法回顾性分析我院经病理证实的20例单发囊变胶质瘤及18例单发囊变转移瘤患者的单体素1H-MRS检查,并对两种肿瘤的实体区、囊变区及周围水肿区的胆碱(Cho)峰、乳酸峰、N-乙酰天门冬氨酸(NAA)、肌酸(Cr)峰等形态观察及峰值测量,计算Cho/NAA、Cho/Cr及NAA/Cr,并进行统计分析。结果在胶质瘤组与转移瘤的廇周水肿区的Cho/NAA、Cho/Cr及NAA/Cr,肿瘤实体区Cho/NAA、Cho/Cr、囊变区的Cho/Cr与NAA/Cr间存在统计差异(p<0.05),在肿瘤实体区的NAA/Cr及囊变区的Cho/NAA,胶质瘤组与转移瘤组间不具统计学差异,p>0.05。结论肿瘤廇周水肿区的1H-MRS图对鉴别囊实性胶质瘤与转移瘤价值最大,肿瘤实体区及囊变区的波普对鉴别诊断也有一定帮助。

Objective To investigate the values of 1HMRS in the differential diagnosis in cystic matastatic encephaloma and glioma.Methods A retrospective analysis of 1HMRS was performed on 20 patients with solitary cystic matastatic encephaloma and 18 patients with solitary cystic glioma.All lesions were proved of pathology.The morphology and peak height would be measured and analysised of Choline peak,lactic acid peak,N-acetyl aspartic acid（NAA）,creatine（Cr） peak in the entity area,the cystic area and the surrounding edema area of the gliomas group and the metastatic sarcoma.Results Statistical analysis showed that there were significant difference for Cho/NAA,Cho/Cr and NAA/Cr in the edema,Cho/Cr and Cho/Cr in the entity area,Cho/Cr and NAA/Cr in the Cystic area between two tumors（p0.05）.There was no significant difference for NAA/Cr in the edema area and Cho/NAA in the Cystic area between two groups patients（p0.05）.Conclusion 1H-MRS was most useful for the differential diagnosis in the surrounding edema area of the two tumors.And 1HMRS were helpful in the differential diagnosis of the entity area and the cystic area of the two tumors.