^1H-MRS在颅内常见肿瘤中的临床应用

Clinical Study of 1H-magnetic Resonance Spectroscopy in the Diagnosis of Intracranial Tumors

目的探讨氢质子磁共振波谱(1H-MRS)在颅内常见肿瘤中的的临床应用。方法回顾性分析经临床诊断或经手术病理证实的100例患者的MRI及1H-MRS资料,其中胶质瘤42例,转移瘤36例,脑膜瘤22例。计算瘤体及瘤周水肿区的Cho、Cr、NAA的浓度及Cho/Cr、NAA/Cr、NAA/Cho的比值。结果胶质瘤、转移瘤、脑膜瘤三者之间肿瘤实质区的Cho/Cr、NAA/Cr、NAA/Cho平均值与参照区比较有显著差异(p<0.05);高、低级别胶质瘤间瘤周水肿区的Cho/Cr、NAA/Cho具有统计学差异(p<0.05),高级别胶质瘤与转移瘤间瘤周水肿区的Cho/Cr、NAA/Cho具有统计学差异(p<0.05)。结论1H-MRS是从微观水平分析脑肿瘤代谢信息的无创性方法,在鉴别诊断颅内肿瘤中有重要价值。

Objective To explore the clinical value of 1H-MRS in the differential diagnosis of intracranial tumors. Methods MRI and 1H-MRS data of 100 patients confirmed by clinical or histopathologic results were analyzed retrospectively, including 42 gliomas, 36 metastases and 22 meningiomas.The concentration of Cho、Cr and NAA and the ratio of Cho/Cr、NAA/Cr and NAA/Cho in tumor parenchyma and peritumoral edema were calculated. Results The ratios of Cho/Cr、NAA/Cr and NAA/Cho, among gliomas、metastases and meningiomas, from which tumor parenchyma showed significant differences when compared with that of normal brain tissues（p〈0.05）.In voxels of peritumoral edema, the ratios of Cho/Cr and NAA/Cho splid high and low grade gliomas presented significant differences（p〈0.05）, meanwhile the ratios of Cho/Cr and NAA/Cho between high grade gliomas and metastases revealed significant differences（p〈0.05）. Conclusion 1H-MRS is a powerful noninvasive method for the study of metabolism of brain tumor in the level of microcosm and is a very important and useful tool in evaluating intracranial tumors.