多体素^1H-MRS在脑肿瘤强化周围区域中的临床应用  

Clinical Study on Perienhancement Area of Brain Tumors with Multivoxel ^1H - MRS

作　　者：麦筱莉[1] 储成凤[1] 秦伟[1] 金琴娣[1] 孟爱芳[1] 张俭[1] 

机构地区：[1]东南大学附属中大医院放射科,江苏南京210009

出　　处：《实用放射学杂志》2006年第5期523-527,共5页Journal of Practical Radiology

摘　　要：目的探讨多体素1H磁共振波谱(1H-MRS)在颅脑肿瘤强化周围区的代谢物改变特点及其鉴别诊断意义。方法脑肿瘤患者35例,多体素1H-MRS采集NAA、Cho、Cr、Lac、L ip、m I和A la峰,分别计算星形细胞瘤、转移瘤、脑膜瘤的肿瘤强化区、强化周围区和正常参照区域的代谢物浓度,计算不同脑肿瘤、同种脑肿瘤不同区域及高、低级胶质瘤各代谢物比值平均值,比较统计学差异,记录Lac、L ip、m I和A la是否出现。结果肿瘤强化区NAA/Cho、NAA/Cr和Cho/Cr平均值与正常参照区比较均有显著性差异(P<0.05);共出现17例Lac峰、7例L ip峰、6例A la峰和6例m I峰;强化周围区,三者的NAA/Cho、NAA/Cr、NAA/nCr、Cho/NAA值具显著性差异;良、恶性胶质瘤间,NAA/Cho、NAA/nCr、Cho/Cr和Cho/nCho值具有统计学差异(P<0.05)。结论多体素1H-MRS对肿瘤强化周围区域的评价,有助于星形细胞瘤与脑转移瘤、脑膜瘤的鉴别诊断及浸润范围的划定。Objective To investigate the predictive value of multivoxel proton magnetic resonance spectroscopy （ ^1H - MRS ） in discussing the metabolic changes in perienhancement area of brain tumors and to evaluate the role of ^1H - MRS in differentiation of brain tumors. Methods 35 patients with intracranial tumors were recruited in this study. Muhivoxel ^1H - MRS was performed and spectra of three voxels were taken from enhanced - solid part of the tumors, perienhancement region （ with T2 hyperintensement areas） and normal white matter. Fitted areas in the spectrum for NAA, Cho, Cr, Lip, Lac, mI and Aia metabolite peaks were measured and NAA/Cho, NAA/Cr, Cho/Cho （normal） , Cho/nCr ratios were calculated for each voxel. One way, ANOVA was used for statistical analysis in metabolic ratio＇s difference among the brain tumors. Results In multivoxel ^1H - MRS from the parenchyma of the lesion, the ratios of NAA/Cho, NAA/Cr and Cho/Cr changed significantly by comparing with that of normal control brain tissues （ P 〈 0.05 ）. Lac occurred in 17 cases, lip presented to 7 cases. Six showed Ala peak while 6 had high mI peak. On the other hand, in voxel from pefienhancement region, NAA/Cho, NAA/Cr, NAA/nCr and Cho/NAA ratios revealed strong correlations between metabolite concentrations and tumor types （ P 〈 0.05 ）. The metabolic ratio between malignant and benign gliomas was significantly difference . Conclusion Evaluation of perienhancement region of brain tumors with multivoxel ^1H- MRS may be useful in the diagnosis, differentiation and deciding the border of brain tumors.

关 键 词：脑肿瘤 磁共振成像 多体素 磁共振波谱学 

分 类 号：R734.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]