~1H-MRS分析鉴别胶质瘤术后复发与放射性脑损伤诊断价值

Diagnostic Value of 1 H -- MRS analysis of multi -- parameter in distinction of brain gliomarecurrence and post radiation brain injuries

目的 1 H-MRS鉴别脑胶质瘤术后复发与放射性脑损伤的价值。方法对18例脑胶质瘤术后放疗后出现异常强化区的患者进行1 H-MRS检查。分析复发和放射性脑损伤的1 H-MRS表现,对复发、损伤、正常脑白质病灶的Cho、Cr、NAA峰高与Cho/Cr、Cho/NAA值进行统计学分析,并根据ROC曲线确定比值参数(Cho/Cr、Cho/NAA)的最佳诊断阈值及诊断准确率。结果复发灶Cho/Cr(2.672士0.694)、Cho/NAA(3.116±1.016)高于损伤灶Cho/Cr(1.297±0.312)、Cho/NAA(1.335±0.253),差异有统计学意义(P<0.05)。结论 1 H-MRS可明显提高复发与损伤的鉴别诊断准确率,对放射性脑损伤的早期确诊具有重要应用价值。

Objective To investigate the value of 1H--MRSin distinction of brain glioma recur- rence and post--radiation brain injuries. Methods Eighteen postoperative patients with abnormal enhan- cing lesions underwent 1 H--MRS. Performances of glioma recurrence and post--radiation brain injuries on 1 H--MRS were analyzed, ADC value of contralateral normal white matter and lesions, peaks height of Cho, Cr, NAA and Cho/Cr, Cho/NAA were measured and analyzed statistically. Results Cho/Cr （2. 672 ± 0. 694）. Cho/NAA（3.116 ± 1.016）of recurrent lesions were significantly higher than those of injury lesions （1. 297±0. 312）, （1. 335±0. 253）, respectively（all P 〈 0.05）. Conclusions 1 H--MRS multi--parameter analysis can improve the accuracy of differential diagnosis between brain glioma recur- rence and post--radiation brain injuries, therefore have important application value on the early diagnosis of post--radiation brain injuries.