颅内囊性病变^1H MR波谱分析  

Analysis of intracranial cystic disease on ^1H MR spectroscopy

作　　者：吴光耀[1] 雷皓[1] 孙骏谟[1] 田志雄[1] 黄雄[1] 

机构地区：[1]武汉大学中南医院MRI室,430071

出　　处：《中华放射学杂志》2006年第4期389-392,共4页Chinese Journal of Radiology

摘　　要：目的分析颅内囊性病变^1H磁共振波谱（^1HMRS）成像特征，评价。HMRS在颅内囊性病变中的应用价值。方法52例颅内囊性病变，单体素^1HMRS采集52个病灶，其中Ⅰ-Ⅱ级星形细胞瘤8例、胶质母细胞瘤9例、转移瘤13例、脑脓肿10例、表皮样囊肿4例、蛛网膜囊肿5例、脑囊虫病3例。点分辨波谱（PRESS，TE135ms或270ms）定域序列采集病灶中心。结果（1）8例Ⅰ-Ⅱ级星形细胞瘤仅显示乳酸（Lae）峰。9例胶质母细胞瘤除了显示Lac峰外，有4例显示了低的胆碱类复合物（Cho）和氮-乙酰天冬氨酸（NAA）峰，2例显示脂质（Lip）峰。（2）转移瘤13例，7例仅显示Lae峰，6例显示Cho峰，3例显示低的NAA峰，6例显示Lip峰。（3）10例脑脓肿除了显示Lac峰，9例显示氨基酸（AA）峰，6例显示乙酸盐（Ace）峰，5例显示琥珀酸盐（Sue）峰，5例显示丙氨酸（ma）峰，2例显示Lip峰；没有显示Cho和NAA峰。（4）4例表皮样囊肿显示Lae峰，1例显示Lip峰。5例蛛网膜囊肿中2例显示低的Lae峰，1例显示Lip峰。脑囊虫病3例，显示Lac、Ace、Sue、ma峰；没有显示AA、Cho和NAA峰。结论颅内囊性病变共有Lae峰，没有特异性。AA峰结合Ace、Sue、ma峰的显示对脑脓肿诊断特异性高。Ace、Sue、AJa峰的显示提示脑寄生虫囊肿存在的可能性。MRI结合MRS有助于对颅内囊性病变的定性诊断。Objective To analyze the features of intracrayze the features of intracranial cystic diseases on ^1 H MRS, and to evaluate the applicable value of ^1 H MRS. Methods Fifty-two patients were examinated by single voxel ^1 H MRS, included Ⅰ-Ⅱ graded astrocytomas （ n = 8 ） , glioblastomas （ n = 9 ）, metastasis （n= 13）, brain abscesses （n = 10）, epidermoids （n =4）, anachnoid cysts （n =5）, brain Cysticerciasis （n = 3 ） . Results （ 1 ） There was only Lac in Ⅰ-Ⅱ graded astrocytomas. But in glioblastomas, as were as all showed Lac, 4 cases showed low Cho and NAA and 2 cases Lip. （2） In 13 metastasis patients, 7 cases only presented Lac, 6 cases showed Cho, 3 cases showed low NAA and 6 ones Lip. （3） In brain abscesses, all showed Lac, 9 cases displayed AA, 6 cases showed Ace, 5 cases appeared Suc and Ala, 2 cases had Lip. （4） Four cases of epidermoid showed Lac, one showed Lip. In 4 arachnoid cysts, 2 cases had low Lac, one showed Lip. Three cases of cysticerciasis showed Lac, Ace, Suc, Ala and no AA, Cho, NAA. Conclusion Lac is the most common resonance peak on ^1 H MRS in intracranial cystic diseases and for no diagnostic specificity. AA combined Ace, Suc, and Ala are highly specificity for brain abscess. Ace, Suc and Ala appearance cues the the possible existence of cysticerciasis. ^1H MRS is helpful for the qualitative diagnosis of intracranial disease.

关 键 词：磁共振成像 脑肿瘤 脑疾病 脑脓肿 评价研究 

分 类 号：R445.2[医药卫生—影像医学与核医学]