^1H-MRS和DWI在胶质母细胞瘤与单发转移瘤中的鉴别诊断价值

Differential diagnosis of glioblastoma multiforme from metastatic brain tumor using proton magnetic resonance spectroscopy and diffusion-weighted image

目的评价3T磁共振1 H-MRS和DWI在胶质母细胞瘤与单发转移瘤中的鉴别诊断价值。方法搜集临床和手术确诊的15例胶质瘤(Ⅳ级)和15例转移瘤,采用西门子公司SKYRA 3.0T超导磁共振行常规MRI、1 H-MRS、DWI扫描,测定感兴趣区(包括肿瘤实质区、瘤周水肿区、正常对照区)代谢物比值和ADC值。采用两种大小ROI测定ADC值,分析ROI大小对测量肿瘤实质区域ADC值是否存在影响。使用SPSS 13.0进行统计分析,找出两种肿瘤间具有统计学差别的参数。结果两种肿瘤瘤周的NAA/Cr、Cho/Cr、Cho/NAA及ADC值存在显著性差异(P<0.01),ADC值在两组肿瘤实质间不存在显著性差异(P>0.05)。两种大小ROI测得的肿瘤区ADC值之间不存在显著性差异(P>0.05)。结论肿瘤水肿区1 H-MRS代谢物比值及ADC值在胶质母细胞瘤与单发转移瘤之间存在显著性差异,有助于两者的鉴别。ROI的大小对肿瘤区域ADC值的测量没有显著影响。

Objective To evaluate the value of the diagnosis via 3T MR ^1H-MRS and DWI between glioblastomas and solitary metastases.Methods ^1 H-MRS and DWI were performed on 15 cases of glioma（gradeⅣ）and 15 cases of metastasis.ADC values were measured in solid portion,peritumor zone and contralateral normal area.ADC values were measured by using two kinds of ROI,and whether the size of the tumor lesion ROI areas affect the measured parameter values was analyzed.The parameters of statistical difference between the two types of tumors were identified by using SPSS13.0statistical analysis.Results There were statistically significant（P〈0.01）among NAA/Cr,Cho/Cr,NAA/Cho and ADC values in peritumoral edema between high-grade gliomas and metastases,ADC values did not exist significant differences（P〉0.05）between the two tumor solid portion.The two different ROI methods applied in the intratumoral region of the tumor groups showed no statistical difference（P〉0.05）.Conclusion ^1 H-MRS and ADC values of peritumoral edema may be helpful in differential diagnosis between glioblastomas and solitary metastases.The size of two kinds of ROI has no significant effect on ADC values.