星形细胞肿瘤术后瘤床区域的MRS特征

MR Spectroscopic Characteristics of Postoperative Tumor Bed in Astrocytic Tumors

目的 ：研究星形细胞肿瘤术后瘤床区域的MRS改变。方法 ：本研究包括手术组和对照组。均采用GE Signa VH/i 3.0T成像系统进行检查,MRS采用多体素PRESS序列。手术组共18例,年龄9~67岁（平均46±14岁）。其中胶质母细胞瘤（WHO4级）7例,间变性星形细胞瘤（WHO 3级）4例,弥漫性星形细胞瘤（WHO2级）6例,毛细胞型星形细胞瘤（WHO1级）1例。MRS测量两个体素：肿瘤床区和对侧正常区。对照组包括18例健康志愿者,体素位置选择在右半卵圆中心区。结果 ：星形细胞肿瘤术后肿瘤床区的MRS表现为NAA/Cr降低,Cho/Cr、Cho/NAA、Lip0.9/Cr及Lip1.3/Cr升高;而对侧正常区只出现NAA/Cr的降低。结论 ：MRS可以对星形细胞肿瘤术后的代谢物改变进行检测,有利于今后对肿瘤治疗后的反应进行评估。

Purpose： To study metabolic changes of postoperative tumor bed in astrocytic tumors detected with MR Spectroscopy. Methods： Two groups were included in this study： operation group and control group. MR Spectroscopy was performed with 2-D multi-voxel PRESS sequence using a GE signa VH/i 3.0T MR unit. There were 18 cases aged 9-67 years （mean age 46-4-14 years） in operation group. Of these 18 cases, 7 were with glioblastomas, 4 with anaplastic astrocytomas, 6 with diffuse astrocytomas and 1 with pilocytic astrocytoma. Two voxels were selected, one located at the tumor bed and the other located at the contralateral normal brain. There were 18 healthy adult volunteers in control group. For the MRS of them, the voxel was located at right centrum semiovale. Results： MR Spectroscopy in postoperative patients revealed a statistically significant decrease in the NAA/Cr ratio and increases in the Cho/Cr, Cho/NAA, Lip0.9/Cr, and Lipl.3/Cr ratios at the tumor bed, and a statistically significant decrease in the NAA/Cr at the controlateral normal brain. Conclusion： MR Spectroscopy is able to detect metabolic changes of postoperative tumor bed, and can help to evaluate the treatment response of astrocytic tumors in the future.