摘要
目的：探讨磁共振动态磁敏感增强（DSC）灌注和氢质子2D－多体素波谱扫描在鉴别脑实质内高级别胶质瘤和脑转移瘤中的临床应用价值。方法：对术前进行了磁共振DSC灌注和氢质子2D－多体素波谱检查并经病理证实的16例高级别胶质瘤及9例脑转移瘤进行回顾性分析，分别测量瘤体最大灌注区、瘤周水肿区及T2高信号边缘区的相对脑血容量，同时测量波谱扫描层面瘤体最大灌注区及瘤周区波谱代谢物比率Cho/NAA、Cho/Cr、NAA/Cr，统计分析上述结果在两类肿瘤中的差异。结果：高级别胶质瘤和转移瘤的瘤体最大灌注区、T2高信号边缘区的相对脑血容量灌注值在组间无显著性差异，而瘤周区高级别胶质瘤组明显高于转移瘤组（P＝0.023）；2D－多体素波谱结果显示高级别胶质瘤组瘤体最大灌注区Cho/NAA、Cho/Cr值及瘤周水肿区Cho/NAA值显著高于转移瘤组。结论：磁共振DSC灌注成像及氢质子2D－多体素波谱扫描技术能提供肿瘤瘤体及瘤周肿瘤血管新生和代谢物的情况，有助于高级别胶质瘤和转移瘤的鉴别诊断。
Abstract
Objective: To assess the clinical application value of dynamic susceptibility contrast(DSC) MR perfusion and 2D-Multivoxel 1H MR spectroscopy in the differentiation of high-grade gliomas and cerebral metastases. Methods: Retrospective analysis all patients’ data who with histopathologic diagnosis of high-grade gliomas(n=16) and metastases(n=9) underwent DSC-MR perfusion imaging and 2D-Multivoxel 1H MR spectroscopy before surgery. The data were analyzed retrospectively. The ratios of relative cerebral blood volume(rCBV) were measured in the regions of tumor, peritumoral and marginal regions with T2 hyperintensity respectively. Simultaneously, the interesting voxel Cho/NAA, Cho/Cr, NAA/Cr ratios were calculated in the peritumoral area and in the maximum perfusion area of tumor in the MRS slice. The difference of the these data have been analysed statistically. Result: There are no significant difference of rCBV in the maximum perfusion area of tumor and marginal zone with T2 hyperintensity between high-grade glomas group and metastases group. But, the value of rCBV of high-grade glomas group is significantly higher than metastases group(P＝0.023). The results of 2D-Multivoxel 1H MR spectroscopy demonstrated that the ratio of Cho/NAA, Cho/Cr in the maximum perfusion area of high-grade glomas group tumor and the Cho/NAA in the peritumoral area were more higher than those of the metastases group significantly. Conclusion: DSC-MR perfusion imaging and 2D-Multivoxel 1H MR spectroscopy can offer the information of angiogenesis and metabolin in tumor and peritumoral area, so these techniques will be usefull in differentiating metastases form high-grade gliomas.
关键词
神经胶质瘤 /
肿瘤转移 /
磁共振成像 /
磁共振波谱学
Key words
Glioma /
Neoplasms metastasis /
Magnetic resonance imaging /
Magnetic resonance spectroscopy
吴雪斌;张伟国;谭 勇;马长锁.
磁共振灌注及波谱成像在鉴别高级别胶质瘤和转移瘤中的应用[J]. 中国临床医学影像杂志. 2010, 21(6): 381-384
WU Xue-bin;ZHANG Wei-guo;TAN Yong;MA Chang-suo.
Using perfusion and proton spectroscopic MRI in the differentiation of high-grade gliomas and cerebral metastases[J]. Journal of China Clinic Medical Imaging. 2010, 21(6): 381-384
中图分类号：
Ｒ739.41
Ｒ730.264
Ｒ73-37
Ｒ445.2
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