磁共振波谱导航在颅内病变穿刺活检中的应用

Preliminary Application of Magnetic Resonance Spectroscopy Guided Navigation in Needle Biopsy of Intracranial Lesions

目的:探讨氢质子磁共振波谱(proton magnetic resonance spectroscopy,1H-MRS)代谢影像导航在脑内病变穿刺活检中的应用。方法:选择颅内部病变患者28例,采用1H-MRS分析病灶组织的生化及代谢情况,采用自主设计软件Biopsy NAV将MRS代谢影像与3D结构影像融合,设计合理的穿刺轨迹和靶点,取得穿刺病理标本。28例中27例患者穿刺活检后再行开颅手术切除病灶并进行病理学检查。结果:28例颅内部病变患者病理诊断成功率100%(28/28)。穿刺病理与术后病理学检测符合率100%(27/27),所有患者术中及术后均未出现明显并发症。结论:1H-MRS代谢影像导航能提供病变的代谢信息并帮助确定最佳活检取材点,穿刺活检诊断成功率较常规结构影像导航高。

Objective：To explore the application of 1H-MRS guided navigation in needle biopsy of intracranial lesions . Methods ：1H-MRS was used in 28 patients with intracranial lesions to analyze the biochemical and metabolic situation of the le-sions and find out the optimal puncture path and biopsy target to get pathological specimens ,by combining the 1H-MRS meta-bolic image and frame image together with independently designed software Biopsy NAV .Among them ,27 patients accept cra-niotomy and pathology inspection after needle biopsy .Results：In all 28 cases with introcranial lesions ,the pathologic diagnosis success rate is 100% （28/28） .The pathological diagnosis made from needle biopsy was 100% （27/27） in accordance with post operative pathology inspection .None of the patients suffered from significant complications during and after the operation . Conclusions ：1H-MRS is useful in analyzing metabolism of the lesions and selecting the best biopsy target ,so that the needle bi-opsy success rate is higher than common frame image navigation .