摘要
目的：探讨多体素氢质子磁共振波谱（1H-MRS）对脑高级别星形细胞瘤、单发脑转移瘤的鉴别诊断价值.方法：收集经手术、活检病理证实的颅脑肿瘤患者37例,其中高级别星形细胞瘤（Ⅲ～Ⅳ级）17例（间变性星形细胞瘤5例,胶质母细胞瘤12例）,脑单发转移瘤20例.37例行颅脑常规MRI检查及多体素1H-MRS分析,分析肿瘤实质强化区、强化边缘区、对侧相应正常区域脑组织的生化代谢物及其比值,并进行对照.结果：①脑高级别星形细胞瘤、脑转移瘤1 H-MRS与对侧相应正常区域对比均表现为Cho峰升高,NAA、Cr峰下降.12例胶质母细胞瘤中,显示Lip峰者11例.20例脑转移瘤中,11例见Lac峰升高,9例Lip峰升高.②高级别星形细胞瘤肿瘤实体区的Cho/NAA明显高于脑转移瘤（P＜0.05）;高级别星形细胞瘤瘤周水肿的Cho/Cr、Cho/NAA明显高于脑转移瘤（P＜0.05）.结论：3.0 T 1H-MRS分析对高级别星形细胞瘤、脑单发转移瘤的诊断和鉴别诊断有重要价值,可作为一种非损伤性的鉴别手段;肿瘤瘤周水肿带的波谱更有利于胶质瘤与转移瘤的鉴别.
Objective：To assess the value of multi-voxel proton MR spectroscopy （MRS） in differentiating solitary brain metastases and high-grade gliomas. Methods： 37 patients with histologically verified brain tumors were collected： 17 patients with high-grade gliomas （5 AA and 12 GBM） and 20 patients with metastatic brain tumors. All patients were underwent MRI and MRS. The metabolite ra- tios of Cho/Cr, Cho/NAA, NAA, Cr and MI were assessed from spectral maps in the tumoral core, peritumoral edema, and contralateral normal-appearing white matter. Results：The ratios of Cho/Cr,Cho/NAA increased and NAA and Cr peak decreased in the parenchymal core of brain tumors compared with normal tissue. The ratio of Cho/Cr in the neoplasm entity of the high-grade gliomas was significantly higher than that in the metastases （P〈0.05）, and the ratios of Cho/Cr,Cho/NAA of the surrounding edema area of high-grade glio mas were significantly higher than that in the metastatic sarcoma （P〈0. 05）. Conclusion.. MRS has value in detecting and differentiating high-grade astrocytomas from solitary intraeranial metastases.
出处
《中国中西医结合影像学杂志》
2014年第5期460-462,F0002,共4页
Chinese Imaging Journal of Integrated Traditional and Western Medicine
基金
青岛市公共领域科技支撑计划项目[2012-1-3-1-(21)-nsh]
