磁共振成像、氢质子磁共振波谱检查对中枢神经细胞瘤的诊断价值

Diagnostic value of magnetic resonance imaging and hydrogen ion magnetic resonance spectroscopy for central neurocytoma

目的对中枢神经细胞瘤(CNC)应用磁共振成像(MRI)和氢质子磁共振波谱(~1H-MRS)鉴别诊断的临床价值进行探讨.方法对2010年2月至2018年2月衢州市人民医院诊治的经手术病理确诊的CNC患者12例临床资料进行回顾性分析,均在术前接受颅脑MRI诊断,其中9例接受~1H-MRS检查.结果该组12例患者,9例发生于侧脑室部前2/3区,2例发生于侧脑室后1/3区,1例发生于额叶;11例为实性肿瘤,1例为囊性肿瘤;MRI表现肿瘤内可见斑状钙化点,纡曲血管影,T1WI为等低信号,T2WI为等高混杂信号;增强后8例呈不均匀轻中度强化,3例不均匀强化,1例为环状强化;8例~1H-MRS表现是胆碱峰(Cho)明显增高,N-乙酰天冬氨酸(NAA)峰明显降低,而Cho/NAA增高;同时,1例甘氨酸峰(Gly)增高.结论CNC有着特异性MRI表现,在术前诊断及鉴别诊断中有着重要作用,同时联合~1H-MRS检查,可自分子水平无创性掌握肿瘤生化指标与代谢情况,提高术前诊断准确性.

Objective To analyze the clinical value of magnetic resonance imaging ( MRI) and hydrogen proton magnetic resonance spectroscopy (~ 1H - MRS) in the diagnosis of central neurocytoma (CNC). Methods From February 2010 to February 2018,the clinical data of 12 patients with CNC confirmed by surgery and pathology in Quzhou People's Hospital were retrospectively analyzed. All patients underwent MRI diagnosis before operation. Among them,9 patients received ~ 1H - MRS check. Results In this group of 12 patients,9 patients occurred in the 2 /3 area of the lateral ventricle,2 cases occurred in the posterior third of the lateral ventricle,1 case occurred in the frontal lobe;11 cases were solid tumors,and 1 case was cystic tumors. MRI showed plaque calcification in the tumor, distortion of vascular shadow,T1WI was equal low signal,T2WI was contoured mixed signal;8 cases showed uneven light and moderate enhancement,3 cases showed uneven enhancement,1 case showed ring enhancement;8 cases of ~ 1H - MRS showed a significant increase in choline peak ( Cho),N - acetylaspartate ( NAA) peak decreased,and Cho /NAA increased. Meanwhile, 1 case of glycine peak ( Gly) increased. Conclusion CNC has specific MRI performance,and plays an important role in preoperative diagnosis and differential diagnosis. Combined with ~ 1H - MRS examination,it can grasp the tumor biochemical index and metabolism from the molecular level and improve the accuracy of preoperative diagnosis.