基于MRS的脑转移瘤伽玛刀疗效分析

郭琪; 张雪宁; 吴梦琳; 时代; 魏璐; 徐德生; 张宜培

中国临床医学影像杂志 ›› 2015, Vol. 26 ›› Issue (1) : 9-13.

论著

基于MRS的脑转移瘤伽玛刀疗效分析

郭琪，张雪宁，吴梦琳，时代，魏璐，徐德生，张宜培

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MRS-based efficacy assessment of brain metastasis treatment by GKS

GUO Qi, ZHANG Xue-ning, WU Meng-lin, SHI Dai, WEI Lu, XU De-sheng, ZHANG Yi-pei

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摘要

目的：通过磁共振波谱（MRS）检测脑转移瘤伽玛刀（GKS）治疗前后各代谢物水平的变化以评估其疗效，探索MRS在脑转移瘤伽玛刀术后疗效随访中的应用价值。方法：收集接受GKS治疗且经病理或临床证实的24个脑转移瘤病灶，于GKS治疗前24小时内、治疗1月及4月后行cMRI及MRS扫描。计算肿瘤体积，并测得各代谢物值。采用ANOVA分析比较GKS治疗前后肿瘤实质区各代谢物的变化，对肿瘤体积变化采用Kruskal-Wallis检验、Wilcoxon秩和检验。结果：①肿瘤体积在GKS治疗前、治疗后1月及4月三个时间点的变化具有统计学意义（P＜0.05），但治疗1月后与治疗前比较无统计学意义，而4月后与治疗前相比具有统计学意义（P＜0.05）。②肿瘤代谢物中，在GKS治疗前、治疗1月及4月后三个时间点的肿瘤nCho、Cho/Cr、Cho/NAA及Cho/cNAA值的变化具有统计学意义（P＜0.05），随访至1月、4月时分别与治疗前相比，肿瘤nCho、Cho/Cr、Cho/NAA及Cho/cNAA值具有统计学意义（P＜0.05）。结论：MRS可对脑转移瘤GKS的早期治疗效果进行评价，结合cMRI可更准确判断术后疗效。

Abstract

Objective: To assess the efficacy of GKS and its clinical value during follow-up by detecting changes in MRS metabolite levels before and after brain metastasis treatment. Methods: 24 lesions of brain metastasis were treated with GKS, which were confirmed by clinical or pathology. MRI with contrast and MRS were performed within 24 hours to evaluate target lesions before GKS treatment, 1 month and 4 months after treatment. Tumor volumes were calculated, and metabolite contents were measured with post-processing software. Changes of metabolite contents in tumor parenchyma before and after GKS treatment were analyzed by ANOVA, and tumor volumes were compared by Kruskal-Wilcoxon and Wilcoxon rank sum test. Results: The changes of tumor volumes before GKS treatment, 1 month and 4 months after treatment were statistically significant (P＜0.05). There was no statistical significance before and 1 month after treatment, and only tumor volumes before and 4 months after treatment were statistically significant(P＜0.05). The changes of nCho, Cho/Cr, Cho/NAA and Cho/cNAA before GKS treatment, 1 month and 4 months after treatment were statistically significant(P＜0.05). Conclusions: MRS is able to show early responses of GKS treatment on brain metastasis and will evaluate GKS efficacy more accurately by combination with contrast MRI.

导出引用

郭琪;张雪宁;吴梦琳;时代;魏璐;徐德生;张宜培. 基于MRS的脑转移瘤伽玛刀疗效分析[J]. 中国临床医学影像杂志. 2015, 26(1): 9-13

GUO Qi;ZHANG Xue-ning;WU Meng-lin;SHI Dai;WEI Lu;XU De-sheng;ZHANG Yi-pei. MRS-based efficacy assessment of brain metastasis treatment by GKS[J]. Journal of China Clinic Medical Imaging. 2015, 26(1): 9-13

中图分类号： Ｒ739.41 Ｒ445.2