3.0T多体素磁共振质子波谱在常见颅内肿瘤鉴别诊断中的价值

Role of 3.0T multi-voxel 1 H magnetic-resonance microscopy in differential diagnosis of common cerebral neoplasms

目的探讨3.0T多体素磁共振质子波谱(1H-MRS)对脑部肿瘤的诊断与鉴别诊断中的应用价值。方法病理证实的颅内肿瘤患者29例:脑膜瘤8例,胶质瘤14例,转移瘤7例。所有患者均常规行3.0T MRI平扫及增强扫描,并运用1H-MRS分析;检测肿瘤组织区、瘤周组织区和对侧正常脑组织区乙酰天门冬氨酸(NAA)、含胆碱类物质(Cho)和含肌酐类物质(Cr),比较NAA/Cho、NAA/Cr和Cho/Cr比值。结果脑肿瘤的1 H-MRS与正常脑组织明显不同,表现为NAA/Cr及NAA/Cho比值降低,Cho/Cr比值升高。在高级别胶质瘤区中NAA/Cho值比低级别下降明显(P<0.05)。脑膜瘤与胶质瘤实质区各项代谢比值均有统计学差异(P<0.05)。三组肿瘤瘤周区仅NAA/Cho比值差异有统计学意义(P<0.05)。结论多体素1H-MRS可以在分子水平上有助于胶质瘤、脑膜瘤和转移瘤的鉴别诊断。

Objective To evaluate the value of 3. 0T multi-voxel 1H magnetic-resonance microscopy（MRS） in the differential diagnosis of common intracranial tumors. Methods The pathological diagnosis of 29 patients was meningioma in 8 cases, glioma（grade I-H in 7 cases and grade Ⅲ-Ⅳ in 7 cases） in 14 cases, intracranial metastatic tumors in 7 cases. All cases underwent 3.0T routine MR and enhancement scanning. Taking 1H-MRS with chemical shift imaging （CSI） method, the ratio of NAA to Cho, NAA to Cr, and Cho to Cr in the tumors and tumor-adjacent normal brain tissues were detected and compared. Results The 1 H MRS of tumors was different from that of normal brain tissues. The ratios of of NAA to Cho and NAA to Cr decreased, whereas the ratio of Cho toGr increased. The ratio of NAA to Cr was lower in the low-grade than that in the high-grade gliomas （P〈0. 05 ）. Three ratios were significantly different between gliomas and meningiomas （P〈0. 05）. The ratio of NAA to Cho in tumor-adjacent normal brain tissues was significantly different among three types cerebral neoplasms（P〈0. 05）. Conclusion Multi-voxel 1H-MRS is useful in the differential diagnosis of common intracranial tumors.