~1H磁共振波谱在恶性胶质瘤与脑单发转移瘤鉴别诊断中的应用

Differentiation between High-Grade Gliomas and Solitary Metastases Using Proton MR Spectroscopy

目的 :探讨1H磁共振波谱 ( 1HMRS)鉴别恶性胶质瘤与脑单发转移瘤的价值。材料和方法 :选择经病理证实的 2 2例单发脑肿瘤患者 ( 14例脑胶质瘤 ,8例脑转移瘤 )术前行常规和增强MRI扫描及1HMRS。对其中 16例患者术后 6个月后进行MRI复查。结果 :14例脑胶质瘤患者胆碱复合物波高高于脑转移瘤 ;肿瘤增强区肌醇波高及肿瘤周围区谷氨酸及谷氨酰胺 (Glu n)波高高于脑转移瘤。 8例脑转移瘤患者肿瘤增强区Glu n波高高于脑胶质瘤。术后复查MRI,3例出现复发 ,1HMRS显示Glu n及脂质波高显著升高 (占 18.8% )。结论 :1HMRS鉴别恶性胶质瘤与脑单发转移瘤有诊断价值 ,并可对预后判定提供帮助。

Purpose: To evaluate proton MR spectroscopy ( 1HMRS) in the differentiation between high-grade gliomas and solitary metastases. Materials and Methods: Twenty-two patients with solitary brain tumors (14 gliomas, 8 metastases) confirmed by pathology underwent conventional, Gd-DTPA enhanced T1-weighted images, and 1HMRS before surgical resection, 16/22 patients received MR imaging reexamination, half years after surgical resection. Results: Of 14 patients with gliomas, choline peaks were elevation compared with those of metastases; both myo-inositol peaks in tumoral regions and glutamate/ glutamine (Glu-n) peaks in peritumoral regions were elevation compared with those of metastases (P <0.01). Of 8 patients with metastases, Glu-n peaks in tumoral regions were elevation compared with those of gliomas (P<0.01). Recrudesce was present in 3 patients (2 gliomas, 1 metastasis). Elevated Glu-n and lipid levels were present in all 3 recrudescent patients (account for 18.8%). Conclusion: 1HMRS is recognized as a useful technique for the diagnosis and estimating prognosis of these two kinds of tumors.