磁共振波谱成像检查对脑胶质瘤的诊断价值

Diagnostic value of magnetic resonance spectroscopy in glioma

目的探讨磁共振波谱成像(MRS)检查对脑胶质瘤的诊断价值。方法选取68例疑似脑胶质瘤患者,分别接受常规MRI检查和MRS检查,以病理检查结果为金标准,评估常规MRI、MRS单独及联合检查对脑胶质瘤的诊断价值。比较转移和未转移脑胶质瘤患者肿瘤体区和周围组织区的MRS影像参数,包括N-胰腺天门冬氨酸(NAA)/肌酸(Cr)、胆碱(Cho)/NAA、[脂质(Lip)+乳酸(Lac)]/Cr、Cho/Cr。结果病理检查结果显示,68例疑似脑胶质瘤患者中,阳性41例,阴性27例。常规MRI、MRS联合检查诊断脑胶质的灵敏度、特异度、准确度、阳性预测值、阴性预测值均高于二者单独检查。41例脑胶质瘤患者中,12例患者最终发生转移,29例患者未发生转移,分别作为转移组和未转移组,未转移组患者周围组织区NAA/Cr明显低于转移组,Cho/Cr、Cho/NAA均明显高于转移组,差异均有统计学意义(P﹤0.01)。结论MRS检查对脑胶质瘤有较高的诊断效能,联合常规MRI检查可获得较高的诊断灵敏度、特异度和准确度,可为临床诊疗提供影像学依据。

Objective To explore the diagnostic value of magnetic resonance spectroscopy(MRS)in patients with glioma.Method A total of 68 patients with suspected glioma were selected to receive routine MRI examination and MRS examination respectively.The diagnostic value of routine MRI and MRS examination alone and jointly for glioma was evaluated based on the results of pathological examination.Compare the MRS imaging parameters of tumor body area and surrounding tissue area of patients with and without metastasis,including N-pancreatic aspartic acid(NAA)/creatine(Cr),choline(Cho)/NAA,[lipid(Lip)+lactic acid(Lac)]/Cr,Cho/Cr.Result Pathological examination showed that among 68 patients with suspected glioma,41 were positive and 27 were negative.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of conventional MRI combined with MRS in the diagnosis of cerebral glia were higher than those of the two examinations alone.Among 41 patients with glioma,12 patients eventually metastasized and 29 patients did not metastasize.As the metastatic group and the non-metastatic group,the NAA/Cr in the surrounding tissue area of the non-metastatic group was significantly lower than that of the metastatic group,and Cho/Cr,Cho/NAA were significantly higher than those of the metastatic group,the differences were statistically significant(P<0.01).Conclusion MRS examination has a high diagnostic efficiency for glioma.Combined with conventional MRI examination,it can obtain high diagnostic sensitivity,specificity and accuracy,and provide imaging basis for clinical diagnosis and treatment.