1H-MRS在颅内胶质瘤分级中的应用价值

贺 丹; 杨 丽; 朱青峰; 刘怀军; 傅方望; 张玉笛; 刘宗杰; 李艳华

中国临床医学影像杂志 ›› 2011, Vol. 22 ›› Issue (2) : 77-82.

论著

1H-MRS在颅内胶质瘤分级中的应用价值

贺丹，杨丽，朱青峰，刘怀军，傅方望，张玉笛，刘宗杰，李艳华

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The value of 1H-MRS in cerebral glioma

HE Dan, YANG Li, ZHU Qing-feng, LIU Huai-jun, FU Fang-wang, ZHANG Yu-di, LIU Zong-jie, LI Yan-hua

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摘要

目的：探讨3.0T磁共振氢质子波谱（1H-MRS）相对定量分析对颅内胶质瘤术前分级的临床应用价值。方法：应用GE 3.0T磁共振系统，对32例经病理证实的胶质瘤患者进行1H-MRS检查，观察肿瘤实质区、瘤周水肿区及对侧正常区1H-MRS谱线表现，定量分析各种代谢物Cho/Cr、NAA/Cr、Cho/NAA、Cho/nCho、Lac/Cr比值变化，并与病理结果相对照。另设11例为正常对照组。结果：胶质瘤肿瘤实质区和正常对照组脑组织Cho/Cr、NAA/Cr、Cho/NAA（分别为2.10±1.04，0.84±0.44，2.05±0.70和0.87±0.13，1.43±0.14，0.61±0.10）存在显著性差异（P<0.05）。低、高级别胶质瘤肿瘤实质区Cho/Cr、NAA/Cr、Cho/NAA、Cho/nCho、Lac/Cr比值（分别为1.58±0.63，0.96±0.57，1.74±0.61，1.04±0.81，1.58±0.10和2.62±1.45，0.78±0.31，3.35±0.89，2.14±1.77，2.61±2.75）存在显著性差异（P<0.05）。低、高级别胶质瘤瘤周水肿区Cho/Cr、NAA/Cr、Cho/NAA、Cho/nCho比值（分别为1.43±0.32，0.82±0.45，1.22±0.19，1.23±0.36和2.21±0.49，1.12±0.23，2.09±0.82，1.47±1.13）亦存在显著性差异（P<0.05）。肿瘤实质区Cho/Cr、Cho/NAA、Cho/nCho、Lac/Cr比值与肿瘤的级别呈正相关（r=0.42，0.62，0.41，0.26），NAA/Cr与肿瘤级别呈负相关（r=-0.35），Cho/NAA与肿瘤级别的相关系数绝对值最大（r=0.62），相关性最高。结论：1H-MRS可为术前确定胶质瘤级别提供诊断依据，具有重要临床应用价值。

Abstract

Objective: To approach the clinical application value of correspondance quantitative analysis with 3.0T magnetic resonance spectroscopy(1H-MRS) in grading cerebral glioma before operation. Methods: Thirty-two patients with cerebral glioma confirmed by pathological results were performed with 1H-MRS on GE 3.0T magnetic resonance system. The spectral line in the solid area of tumour, peritumor edematous area and normal-area of the opposite side were observed with 1H-MRS. Cho/Cr, NAA/Cr, Cho/NAA, Cho/nCho, Lac/Cr were analyzed. The results of 1H-MRS were compared with the results of pathology. Another 11 subjects were normal control. Results: There were significant differences in Cho/Cr, NAA/Cr, Cho/NAA between solid area of glioma and normal area of the opposite side(2.10±1.04, 0.84±0.44, 2.05±0.70 and 0.87±0.13, 1.43±0.14, 0.61±0.10 respectively). There were significant differences in Cho/Cr, NAA/Cr, Cho/NAA, Cho/nCho, Lac/Cr between solid area in the low grade glioma group and that in the high grade glioma group that is(1.58±0.63, 0.96±0.57, 1.74±0.61, 1.04±0.81, 1.58±0.10 and 2.62±1.45, 0.78±0.31, 3.35±0.89, 2.14±1.77, 2.61±2.75 respectively)(P<0.05). There were also significant differences in Cho/Cr, NAA/Cr, Cho/NAA, Cho/nCho(i.e. 1.43±0.32, 0.82±0.45, 1.22±0.19, 1.23±0.36 and 2.21±0.49, 1.12±0.23, 2.09±0.82, 1.47±1.13) between edematous area in the low grade glioma group and that in the high grade glioma group(P<0.05). Cho/Cr, Cho/NAA, Cho/nCho, Lac/Cr(r=0.42, 0.62, 0.41, 0.26) of solid area of tumor was of positive correlation with the grade of tumor, and NAA/Cr(r=-0.35) was of negative corretation. The correlative coefficient of Cho/NAA(r=0.62) was the maximum and had maximal dependability with grade of tumor. Conclusion: 1H-MRS had very important clinical application value in providing diagnostic support for grading of cerebral glioma before operation.

导出引用

贺丹;杨丽;朱青峰;刘怀军;傅方望;张玉笛;刘宗杰;李艳华. 1H-MRS在颅内胶质瘤分级中的应用价值[J]. 中国临床医学影像杂志. 2011, 22(2): 77-82

HE Dan;YANG Li;ZHU Qing-feng;LIU Huai-jun;FU Fang-wang;ZHANG Yu-di;LIU Zong-jie;LI Yan-hua. The value of 1H-MRS in cerebral glioma[J]. Journal of China Clinic Medical Imaging. 2011, 22(2): 77-82

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