磁共振波谱成像在良恶性脑膜瘤鉴别诊断中的价值  

Magnetic resonance spectroscopy in differential diagnosis of benign and malignant meningiomas

作　　者：史瑞华[1] 翟仁友[1] 钱晓军[1] 潘振宇[1] 丁毅[1] 鲁万红[1] 孟昭泉[1] 周意明[1] 包娜[1] 顾华[1] 

机构地区：[1]首都医科大学附属北京朝阳医院放射科,北京100020

出　　处：《中国医学影像技术》2006年第5期674-677,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨磁共振波谱(1H MRS)在良、恶性脑膜瘤鉴别诊断中的价值。方法经手术病理证实的36例脑膜瘤在治疗前行常规MRI及1H MRS检查(脑膜瘤Ⅰ级30例,Ⅱ+Ⅲ级6例)。1H MRS检查包括PRESS 35、PRESS 144序列。结果良性脑膜瘤组Cho/Cr比值(3.80±1.08);恶性脑膜瘤组Cho/Cr比值(7.22±0.70)。差异具有显著性(t=7.40,P=0.000)。MRS表现:本组脑膜瘤病例均未测得NAA,可见Cho峰升高、Cr降低。35例可测得特异的Ala峰。36例均测得谷氨酸和谷胺酰胺(Glx)峰。5例恶性脑膜瘤于1.3 ppm处见特异的Lip的亚甲基信号,而良性脑膜瘤中仅有1例纤维细胞型见Lip的亚甲基信号显示。结论脑膜瘤磁共振波谱Cho/Cr比值对脑膜瘤良、恶性鉴别诊断具有重要价值。1.3 ppm处Lip的亚甲基信号多提示为恶性脑膜瘤可能。Objective To investigate the value of ^1H magnetic resonance spectroscopy （^1H MRS） in differentiating benign from malignant menlngiomas. Methods Thirty-slx patients with meningiomas underwent conventional MR and ^1H MRS before surgery （Grade Ⅰ 30 cases; Grade Ⅱ ＋Ⅲ 6 cases）, ^1H MRS sequences included PRESS 35 and PRESS 144. Results The mean ratio of Cho/Cr in the benign and malignant groups were （3.80± 1.08） and （7.22±0.70）, respectively. The difference is significant （t= 7.40, P=0. 000）. The MRS features of menlngiomas were as follows： NAA cannot be detected. Cho increased markedly, Cr decreased evidently and Ala apex is very characteristic. Glx was observed in all cases. A methylene of Lip was detected in all five malignant meninglomas, but only in one benign meningioma （fibrous）. Conclusion ^1H MRS is an useful diagnostic method for differentiating benign from malignant meningiomas according to the Cho/Cr ratio. A methylene signal suggests a high grade tumor.

关 键 词：脑膜瘤 磁共振波谱 鉴别诊断 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]