脑肿瘤应用磁共振弥散联合波谱分析技术诊断的临床价值

Clinical Value of Magnetic Resonance Diffusion Spectroscopy in the Diagnosis of Brain Tumors

目的探讨磁共振弥散加权成像(DWI)联合波谱分析技术(MRS)应用于临床诊断脑肿瘤的价值。方法回顾性分析资料完整经手术及组织病理学确诊为脑肿瘤的78例患者临床和影像资料。所有患者均行磁共振扫描检查,并予弥散加权成像及波谱分析。比较不同脑肿瘤及其对侧正常区域脑组织的ADC值,记录不同肿瘤代谢物变化情况。结果脑膜瘤平均ADC值明显高于对侧正常区域脑组织ADC值,差异有统计学意义(t=7.96,P<0.05);脑转移瘤平均ADC值高于对侧正常区域脑组织ADC值,差异有统计学意义(t=4.94,P<0.05);星形细胞瘤平均ADC值为高于对侧正常区域脑组织ADC值,差异有统计学意义(t=9.09,P<0.05)。脑膜瘤、脑转移瘤和星形细胞瘤之间ADC值方差分析无统计学意义(P>0.05)。I-II级星形细胞瘤与III^IV级星形细胞瘤ADC值差异有统计学意义(t=7.18,P<0.05),与对照侧正常组织差异有统计学意义(P<0.05)。脑转移瘤、脑膜瘤及星形细胞瘤NAA水平明显低于正常脑组织NAA水平,差异有统计学意义(P<0.05);星形细胞瘤NAA/Cho和NAA/Cr值明显高于脑转移瘤、脑膜瘤,差异有统计学意义(P<0.05)。结论磁共振弥散成像对脑肿瘤诊断和鉴别诊断有一定价值,ADC值本身并不能很好鉴别实性肿瘤,联合应用波谱分析技术,并结合常规磁共振检查可对常见脑肿瘤进行定性分析和恶性程度分级,为临床诊断和治疗方案制定提供参考依据。

Objective To investigate the value of diffusion weighted imaging(DWI)and spectral analysis(MRS)in the diagnosis of brain tumors.Methods He clinical and imaging data of 78 patients with brain tumors confirmed by surgery and histopathology were analyzed retrospectively.All patients underwent magnetic resonance imaging,and diffusion weighted imaging and spectral analysis were performed.The ADC values of different brain tumors and their contralateral normal brain tissues were compared,and the changes of metabolites in different tumors were recorded.Results The average ADC value of meningioma was significantly higher than that of the normal side of regional brain tissue ADC,the difference was statistically significant(t=7.96,P<0.05),the average value of ADC for brain metastases higher than the contralateral normal brain region ADC,the difference was statistically significant(t=4.94,P<0.05),the average ADC value of astrocytomas higher than the contralateral normal area of brain tissue ADC,the difference was statistically significant(t=9.09,P<0.05).There was no significant difference in ADC value analysis between meningioma,brain metastasis and astrocytoma(P>0.05).There was significant difference in ADC value between I^II astrocytoma and III^IV astrocytoma(t=7.18,P<0.05),and the difference was statistically significant(P<0.05).Brain metastasis,meningioma and astrocytoma NAA levels were significantly lower than the level of NAA in normal brain tissues,the difference was statistically significant(P<0.05).NAA/Cho and NAA/Cr in astrocytomas was significantly higher than that of brain metastatic tumors and meningiomas,the difference was statistically significant(P<0.05).Conclusion Magnetic resonance imaging of the brain tumor diagnosis and differential diagnosis of a certain value,the value of ADC itself is not a good identification of solid tumors,the combined application of spectrum analysis technology,combining with conventional MRI can classify the qualitative analysis and the degree of common malignant brain tumors,and provide reference for clinical diagnosis and treatment plan.