氢质子波谱在骨肌系统肿瘤诊断中的临床应用

李勇刚; 王仁法; 陈文学; 高小玲; 杨海涛; 李锋; 夏黎明; 王承缘

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中国临床医学影像杂志 ›› 2007, Vol. 18 ›› Issue (10) : 736-740.

论著

氢质子波谱在骨肌系统肿瘤诊断中的临床应用

李勇刚1，王仁法1，陈文学2，高小玲1，杨海涛1，李锋1，夏黎明1，王承缘1

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Hydrogen magnetic resonance spectroscopy in the diagnosis of musculoskeletal system tumors

LI Yong-gang1, WANG Ren-fa1, CHEN Wen-xue2, GAO Xiao-ling1, YANG Hai-tao1, LI Feng1, XIA Li-ming1, WANG Cheng-yuan1

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摘要

目的：研究骨肌系统良、恶性肿瘤的1H-MRS特点，探讨1H-MRS用于骨肌系统肿瘤诊断与鉴别诊断的可行性及价值。材料与方法：本组研究共40例，良性肿瘤组12例，恶性肿瘤组28例。均行常规MRI扫描及在体1H-MRS检查。26例肿瘤新鲜手术标本行离体1H-MRS检查。观察良、恶性肿瘤组织及正常肌肉在体1H-MRS表现，并与肿瘤标本离体1H-MRS检查结果对照，在工作站上测量Cho/Cr及Lipid/Cr比值并进行统计学分析。分析36例肿瘤的细胞密度，并与肿瘤组织Cho/Cr值作Pearson相关性分析。结果：恶性肿瘤组织Cho/Cr比值明显高于良性肿瘤，Lipid/Cr比值低于良性肿瘤，差异均具有显著性意义（P<0.01）。离体波谱研究显示，与良性肿瘤组织相比，18例恶性肿瘤组织的Cho、Lac与mI峰都明显升高，而Lip、Glc则明显下降，12例恶性肿瘤Ala、Glu、PC、Gly峰增高。在体波谱Cho峰及Lipid峰变化趋势与离体波谱具有较高的一致性。恶性肿瘤平均细胞密度为150/视野，良性肿瘤平均细胞密度为61/视野，两者差异具有显著性意义。肿瘤细胞密度与Cho/Cr值呈明显正相关（r=0.882，P<0.001)。结论：良、恶性骨肌系统肿瘤1H-MRS表现明显不同，在体与离体1H-MRS具有较高的一致性，在体1H-MRS对骨肌系统肿瘤的诊断与鉴别诊断具有较高价值。

Abstract

Objective: To investigate the proton magnetic resonance spectroscopy(1H MRS) features of benign and malignant musculoskeletal system tumors in human and to explore its feasibility and application value in the differentiation diagnosis of musculoskeletal system tumors. Methods: 40 cases were included in the study in which there were 12 cases in benign tumor group and 28 cases in malignant tumor group respectively. MRI and in vivo 1H MRS were performed on all cases and in vitro 1H MRS of fresh samples were studied on 26 cases of soft tissue tumors. The 1H MRS features of all 40 cases were analyzed and the correlation study between in vivo 1H MRS findings and that of in vitro 1H MRS was performed. Cho/Cr and Lipid/Cr were calculated on workstation and a statistic test was done. We caculated the cell density of 36 tumors and performed Pearson correlation analysis between the cell density and Cho/Cr value. Results: The Cho/Cr value in the malignant tumor was larger than in the benign tumor, but the Lipid/Cr value was smaller than in the benign tumor. The differences of Cho/Cr value and Lipid/Cr value between malignant and benign soft tissue tumors were statistically significant(P<0.01). In contrast to benign tumor group, in vitro 1H MRS revealed increased Cho, Lac and mI peak and decreased Lipid and Glc peak in 18 cases of the malignant tumor, as well as increased Ala， Glu， PC and Gly peak in 12 cases of the malignant tumors. In vivo 1H MRS changes of Cho and Lipid peak in the musculoskeletal system tumors was consistent with in vitro 1H MRS. The average cell density was 150/FOV in the malignant tumor group and 61/FOV in the benign tumor group respectively. The difference of the average cell density between the two groups was statistically significant. The value of the cell density had a significant positive correlation with the Cho/Cr value of tumors(r=0.882, P<0.001). Conclusion: The benign and malignant musculoskeletal system tumors in human showed great difference in 1H MRS. In vivo 1H MRS findings demonstrated great consistence with that of in vitro 1H MRS. In vivo 1H MRS has high application value in the differentiation diagnosis of musculoskeletal system tumors.

导出引用

李勇刚;王仁法;陈文学;高小玲;杨海涛;李锋;夏黎明;王承缘. 氢质子波谱在骨肌系统肿瘤诊断中的临床应用[J]. 中国临床医学影像杂志. 2007, 18(10): 736-740

LI Yong-gang;WANG Ren-fa;CHEN Wen-xue;GAO Xiao-ling;YANG Hai-tao;LI Feng;XIA Li-ming;WANG Cheng-yuan. Hydrogen magnetic resonance spectroscopy in the diagnosis of musculoskeletal system tumors[J]. Journal of China Clinic Medical Imaging. 2007, 18(10): 736-740

中图分类号： Ｒ738 Ｒ445.2