脑胶质瘤的二维氢质子磁共振波谱研究  

Role of two dimensional proton MR spectroscopy in diagnosing brain gliomas

作　　者：李建胜[1] 龚洪翰[1] 肖香佐[1] 汪丽娅[2] 

机构地区：[1]南昌大学医学院第一附属医院放射科 [2]广东省深圳市第二人民医院放射科

出　　处：《中国CT和MRI杂志》2006年第3期1-4,共4页Chinese Journal of CT and MRI

摘　　要：目的探讨在体脑胶质瘤的2D1H-MRS表现及其临床应用。方法经病理学证实的胶质瘤30例,分成3组:良性组、过渡组和恶性组。使用1.5TMRI成像仪,PRESS序列,完成扫描后用随机软件包FuncTool进行分析,观察瘤体区、周边区及内参照区各主要代谢物变化情况。结果30例胶质瘤中良性组12例、过渡组10例、恶性组8例。恶性组肿瘤实体区NAA/Cho、NAA/Cr、NAA/(Cho+Cr)较正常参照区降低且具显著性差异(P<0.05);Cho/Cr和Lac/Cr均较参照区升高,前者P<0.05,后者无统计学差异(P>0.05);过渡组肿瘤实体区NAA/Cho、NAA/Cr、NAA/(Cho+Cr)较正常参照区降低且具显著性差异(P<0.05)。NAA/Cr在良性组与恶性组之间有显著性差异(P<0.05);Cho/Cr和NAA/Cho在良性组与过渡组、恶性组之间均有显著性差异(P<0.05),而过渡组与恶性组之间无显著性差异(P>0.05)。Lac/Cr在3组中未见显著性差异(P>0.05)。结论NAA下降、CHo升高和异常Lac峰的出现是胶质瘤的主要波谱表现。2D1H-MRS可以为胶质瘤的影像分级提供一个定量分析的方法。Objective To probe manifestations of in vivo gliomas on graph of 2D proton MR spectroscopy as well as potential clinical applications. Methods 30 patients that had been pathologically confirmed as cerebral gliomas were randomized into 3 groups: benign, transitional, and malignant. All patients underwent 1.5T MRI imaging and PRESS sequence. After scanning, an attached software package FuncTool was used to analyze changes of major metabolites in lesions, surroundings of lesions and interior reference region. Results Among 30 patients, 12 cases were benign, 10 were in transitional stage and 8 were malignant. Mean peak ratios of NAA/Cho, NAA/Cr, NAA/ (Cho+Cr) in malignant tumors were significantly lower than those in the contralateral normal areas (P < 0.05). Cho/Cr and Lac/Cr in the mass were higher than that in reference areas, with the former being significant (P < 0.05) and the latter insignificant (P < 0.05). The mean peak ratios of NAA/Cho, NAA/Cr, NAA/(Cho+Cr) in transitional stage were significantly lower than those in the reference normal areas(P < 0.05). NAA/Cr in the benign group differed significantly from that in the malignant group (P < 0.05). Both Cho/Cr and NAA/Cho ratios in the benign group significantly differed from the remain- ing two groups (P < 0.05), and Cho/Cr and NAA/Cho ratios in the transitional group did not differ from that in the malignant group(P < 0.05). Lac/Cr ratios did not show signifi- cant difference among the three groups(P < 0.05). Conclusion The major proton spectroscopic features of gliomas are increased Cho,decreased NAA and presence of Lac peak. Proton MR spectroscopy provides a quantitative method for grading gliomas on MR images.

关 键 词：磁共振成像 波谱 胶质瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学] R730.264[医药卫生—临床医学]