cMRI结合MRS技术对颅内高级别胶质瘤与转移瘤的应用价值

cMRI combined with MRS in diagnosis of high grade glioma and metastatic tumor

目的分析常规磁共振成像(cMRI)结合磁共振波普(MRS)技术对颅内高级别胶质瘤(HGG)与脑转移瘤(SBM)的应用价值。方法收集本院2014年1月至2019年6月经病理证实的28例HGG及26例SBM患者的临床资料,病变均为单发,分析肿瘤的cMRI及MRS特点。结果HGG瘤体呈T1WI稍低、T2WI稍高信号,内外壁毛糙、厚薄不均,增强后明显环形强化,瘤周水肿16例伴斑片状强化、12例无强化;SBM瘤体呈T1WI稍低、T2WI高信号,内壁毛糙、外壁光整,壁稍厚,增强后环形或结节状强化,瘤周水肿但无强化;HGG及SBM中央坏死区MRS各项数据无明显差异,HGG边缘实质区NAA/Cr值明显低于SBM,差异有统计学意义(P<0.05);HGG周围水肿区Cho/Cr值升高、Cho/NAA值降低,与SBM比较,差异均有统计学意义(均P<0.05)。结论HGG与SBM信号、形态相似,周围均伴明显水肿,cMRI表现存在重叠现象。两者瘤周水肿的强化特点及MRS存在明显差异,MRS结合cMRI有助于诊断,且MRS对HGG肿瘤侵犯范围有一定提示意义。

Objective To analyze the value of conventional magnetic resonance imaging(cMRI)combined with magnetic resonance wave(MRS)in the diagnosis of intracranial high-grade glioma(HGG)and brain metastatic tumor(SBM).Methods The clinical data of 28 cases of HGG and 26 cases of SBM from our hospital were collected;and the lesions were all single.The cMRI and MRS characteristics of the tumors were analyzed.Results The HGG tumor showed slightly lower T1WI and slightly higher T2WI,rough and uneven inner and outer walls,and obvious ring enhancement after enhancement,and peritumor edema with patchy enhancement in 16 cases and no enhancement in 12 cases.The SBM tumor presented slightly lower T1WI and higher T2WI signals,with rough inner wall and smooth the outer wall;the wall was slightly thicker;there were ring and nodule enhancements after enhancement;there was edema around the tumors without enhancement.There were no statistical differences in the MRS data of the central necrosis area between the HGG group and the SBM group.The NAA/Cr value in the HGG marginal parenchyma area was significantly lower than that in the SBM(P<0.05).The Cho/Cr value in the edema area around HGG increased and the Cho/NAA value decreased,with statistical differences from those of SBM(both P<0.05).Conclusion The signals and morphology of HGG and SBM are similar,accompanied with obvious edema around,and the cMRI manifestations overlap.There are significant differences in the enhancement characteristics of peritumor edema and MRS between the two groups.The combination of MRS and cMRI is helpful for the diagnosis,and MRS can indicate the invasion range of HGG tumor to some extent.