MRS和DTI对放疗前后脑胶质瘤瘤周水肿的观察与分析

Observation and analysis about the role of MRS and DTI before and after the radiotherapy of brain gliomas peritumoral edema region

目的:应用MRS和DTI观察脑胶质瘤放疗前、后肿瘤周围水肿区变化。方法:31例病理诊断明确的脑胶质瘤术后患者,分别在放疗前、后行MRI平扫+增强+MRS+DTI检查。分析肿瘤瘤周水肿区代谢物比值的变化[胆碱(Cho)/肌酐(Cr)、Cho/N-乙酰天门冬氨酸(NAA)、NAA/Cr]及部分各向异性(fractional anisotropy,FA)值、ADC值变化。结果:放疗后瘤周水肿区Cho/Cr、Cho/NAA、NAA/Cr值较放疗前下降,其中Cho/Cr差异有统计学意义(P<0.05),Cho/NAA、NAA/Cr值差异无统计学意义(P>0.05);瘤周水肿区域放疗后FA值升高(P>0.05),ADC值下降(P<0.05)。结论:MRS及DTI能显示肿瘤水肿区放疗后的早期变化,较早反映放疗效果。

Objective： To evaluate the MR spectroscopy and diffusion-tensor imaging in the radiotherapy of glioma peritumoral edema region. Methods.. 31 patients with gliomas confirmed by pathology after partial surgical resection underwent routine MR1 contrast-enhanced scanning, MRS and DTI pre and post-radiotherapy （pre-RT and post-RT）. The regions of interest（ROD were placed on peritumoral brain edema region and normal white matter region respectively. The Cho/Cr, Cho/NAA, NAA/Cr rati- os, FA and ADC values were calculated automatically from both pre-RT and post-RT image sequences. Results： Compared to pre-RT, the ratios of Cho/Cr,Cho/NAA, NAA/Cr decreased in regions of peritumoral edema, there were significant differences in Cho/Cr and no significant differences in Cho/NAA, NAA/Cr. FA increased（P〉0. 05） and ADC values decreased（P〈0.05）. Conclusion： MRS and DTI can early provide important information about effect of radiotherapy.