摘要
目的：通过增强后多体素1H-MRS研究肿瘤强化区、强化边缘区的细胞代谢，探讨1H-MRS对高级别胶质瘤和单发转移瘤的鉴别诊断价值。资料与方法：27例颅内肿瘤患者，包括高级别胶质瘤（WHO III~IV级）12例，单发转移瘤15例，行常规MRI和增强后多体素1H-MRS检查。10例年龄匹配的健康志愿者作对比。比较高级别胶质瘤和单发转移瘤强化区及强化边缘区胆碱/肌酸（Cho/Cr），N-乙酰天门冬氨酸/胆碱（NAA/Cho）、N-乙酰天门冬氨酸/对侧正常脑组织肌酸（NAA/Cr-n）比值，并进行比较分析。结果：增强后多体素1H-MRS提示高级别胶质瘤和单发转移瘤强化区均出现NAA/Cho和NAA/Cr-n降低，Cho/Cr升高，两种肿瘤强化区各项比值之间的比较，差异除NAA/Cho（P<0.05）外均无统计学意义（P>0.05）。各个高级别胶质瘤和单发转移瘤强化边缘区之间Cho/Cr比值分别为1.642±0.24和0.862±0.41，NAA/Cho比值分别为0.462±0.32和2.512±1.58，NAA/Cr-n比值分别为0.436±0.22和0.725±0.27，差异均有显著统计学意义（P<0.01）。结论：使用增强后多体素1H-MRS结合常规MRI，有助于提高对高级别胶质瘤和单发转移瘤的鉴别能力。
Abstract
Objective: To discuss post-contrast multivoxel 1H-MRS can be used to differentiate high grade gliomas and solitary metastases on the basis of the differences in metabolite levels in enhancing region and peritumoral region. Materials and Methods: Twenty-seven patients with brain tumor[12 high-grade gliomas(WHO III~IV) and 15 solitary metastases] was performed with conventional MRI and post-contrast multivoxel 1H-MRS. Ten age-matched healthy volunteers underwent post-contrast 1H-MRS for comparison. The Cho/Cr, NAA/Cho, NAA/Cr-n value of enhancing region and peritumoral region were compared respectively between gliomas and metastases. The results were analyzed statistically. Results: All the enhancing regions of the two kinds of tumor were characterized by reduced NAA/Cho, NAA/Cr-n and increased Cho/Cr, which had no significant difference(P>0.05) except NAA/Cho(P<0.05). The Cho/Cr in peritumoral region of the gliomas and metastases was 1.642±0.24 and 0.862±0.41 respectively; the NAA/Cho was 0.462±0.32 and 2.512±1.58 respectively; the NAA/Cr-n was 0.436±0.22 and 0.725±0.27 respectively. All ratios had significant difference(P<0.01). Conclusion: Combining with conventional MRI scan, post-contrast multivoxel 1H-MRS can improve the differential diagnostic ability between high grade gliomas and solitary metastases.
关键词
肿瘤 /
神经上皮 /
肿瘤转移 /
磁共振波谱学
Key words
Neoplasms /
neuroepithelial /
Neoplasm metastasis /
Magnetic resonance spectroscopy
王廷昱;史克珊;梁其州;廖海燕;韩向君.
高级别胶质瘤与单发转移瘤的增强后多体素1H-MRS鉴别[J]. 中国临床医学影像杂志. 2008, 19(12): 842-845
WANG Ting-yu;SHI Ke-shan;LIANG Qi-zhou;LIAO Hai-yan;HAN Xiang-jun.
Differential diagnosis between high grade gliomas and solitary metastases with post-contrast multivoxel 1H-MRS[J]. Journal of China Clinic Medical Imaging. 2008, 19(12): 842-845
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