DWI联合MRS技术对颅内肿瘤定性及恶性程度分级的诊断价值

Application value of DWI combined with MRS in the diagnosis of qualitative and malignant grades in intracranial tumors

目的探讨磁共振弥散加权成像联合波谱分析技术在颅内肿瘤定性及恶性程度分级诊断中的应用价值。方法对76例颅内肿瘤患者进行磁共振检查,并进行磁共振弥散加权成像联合波谱分析技术检查。比较不同类型颅内肿瘤与其对侧正常脑组织表观弥散系数值,比较不同类型颅内肿瘤与正常组织代谢物水平。结果脑膜瘤、脑转移瘤及星形细胞瘤表观弥散系数值均显著高于对侧正常脑组织(P<0.01);脑膜瘤、脑转移瘤及星形细胞瘤间的表观弥散系数值比较差异无统计学意义(P>0.05)。Ⅰ级-Ⅱ级星形细胞瘤表观弥散系数值显著高于Ⅲ级-Ⅳ级星形细胞瘤(P<0.01),且均显著高于对侧正常脑组织(P<0.01)。脑膜瘤、脑转移瘤及星形细胞瘤的N-乙酰天门冬氨酸/肌酸、N-乙酰天门冬氨酸/含胆碱化合物值均显著低于正常组织(P<0.05),含胆碱化合物/肌酸值高于正常组织(P<0.05);星形细胞瘤的N-乙酰天门冬氨酸/肌酸、N-乙酰天门冬氨酸/含胆碱化合物值均显著高于脑膜瘤、脑转移瘤(P<0.05);脑膜瘤的含胆碱化合物/肌酸值均显著高于脑转移瘤及星形细胞瘤(P<0.05)。Ⅰ级-Ⅱ级星形细胞瘤的N-乙酰天门冬氨酸/肌酸、N-乙酰天门冬氨酸/含胆碱化合物值显著高于Ⅲ级-Ⅳ级星形细胞瘤(P<0.05),且显著低于正常组织(P<0.05),含胆碱化合物/肌酸值显著低于Ⅲ级-Ⅳ级星形细胞瘤(P<0.05),且显著高于正常组织(P<0.05)。结论联合采用磁共振弥散加权成像与波谱分析技术可更好地反映患者脑细胞结构的变化情况,为颅内肿瘤定性及恶性程度分级诊断提供更多依据。

Objective To explore the application value of DWI combined with MRS in the diagnosis of qualitative and malignant grades in intracranial tumors. Methods 76 cases of intracranial tumors were given magnetic resonance examination and analyzed by DWI and MRS techniques. The apparent diffusion coefficient (ADC)values of different types of intracranial tumors and their normal brain tissues in contralateral side were statistically compared. The metabolites levels of different types of intracranial tumors and normal tissues were compared. Results The ADC values of meningiomas, brain metastases and astrocytomas were higher than those of normal brain tissues in contralateral side(P<0. 01). There was insignificant difference in ADC value of meningiomas, brain metastases and astrocytomas(P>0.05). The ADC value of astrocytoma in grade I II was higher than that of astrocytoma in grade Ⅲ-Ⅳ, and was higher than that of normal brain tissue in contralateral side(P<0. 01). The values of Nacetyl aspartate (NAA)/ creatine (Cr)and NAA/choline containing compounds (Cho)of meningiomas,brain metastases and astrocytomas were lower than those of normal tissues,and the value of Cho/Cr was higher than normal tissues(P<0.05).The values of NAA/Cr and NAA/Cho of astrocytomas were higher than those of meningiomas and brain metastases(P<0.05).The values of Cho/Cr of meningiomas were higher than those of brain metastases and astrocytomas(P<0.05).The values of NAA/Cr and NAA/Cho of astrocytomas in grade Ⅰ-Ⅱ were higher than those of astrocytoma in grade Ⅲ-Ⅳ,and lower than those of normal tissues (P<0.05),and the value of Cho/Cr was lower than that of astrocytomas in grade Ⅲ-Ⅳ(P<0.05),and higher than that of normal tissues(P<0.05).Conclusion The combined use of DWI and MRS can better reflect the changes in the brain cell structure of the patients,and provide more evidence for the diagnosis of the qualitative and malignant grades of intracranial tumors.