^1H-MRS分析在颅脑肿瘤研究中的临床应用价值  

Clinical Application of ^1 H - MRS in Craniocerebral Tumor

作　　者：谢元亮[1] 张树桐[1] 金朝林[1] 肖建伟[1] 王翔[1] 

机构地区：[1]武汉市中心医院影像科,湖北武汉430014

出　　处：《实用放射学杂志》2006年第6期651-654,685,共5页Journal of Practical Radiology

基　　金：武汉市卫生局临床重点学科研究项目(西医类);编号:2003-14

摘　　要：目的研究脑肿瘤^1H-MRS的不同表现及临床应用价值.方法80例行^1H-MRS检查并经病理证实或临床追踪证实的脑肿瘤患者,取对侧正常部位对照30例.采用激励法进行单体素波谱采集或二维波谱成像,对有显著性差异的代谢物比值均数比较.结果与对照组相比,脑肿瘤NAA均有不同程度的下降,脑外肿瘤低于脑内肿瘤,高级别（Ⅲ一Ⅳ）胶质瘤较低级者（Ⅰ～Ⅱ）下降明显.Cho/Cr升高,高级胶质瘤比低级胶质瘤高（P＜0.05）,高级别胶质瘤及转移瘤瘤体瘤周水肿区Cho/Cr有显著性差异.部分高级别胶质瘤及转移瘤可检测到Lac、Lip峰.部分脑膜瘤（4/19）可检测到Ala峰.结论^1H-MRS从微观水平分析脑肿瘤代谢信息的无创性方法,对脑肿瘤的诊断、鉴别诊断及疗效评估、术后复发、组织上分级有重要帮助.Objective To investigate ^1 H - MRS findings of brain tumor and the clinical application of ^1 H - MRS . Methods 80 patients with brain tumors clinically or pathologically - proved underwent ^1 H - MRS. Normal opposite hemispheres in 30 cases were used as control group. Single voxel spectroscopy（SVS） or 2D- MRS imaging was performed with excited echo sequence. The mean ratio of metabolisms with difference was compared. Results Compared with control group, NAA of tumor decreased in certain degree （ P 〈 0.05）. NAA in extra - encephalic tumors was lower than that of intra - encephalic tumors and lower in high grade gliomas. Cho/Cr of Ⅲ - Ⅳostrocytoma was higher than that of Ⅰ - Ⅱ ostrocytoma （P 〈 0.05）. Cho/Cr of tumor and oedema erea had statistical diference in high grade gliomas and metastases. Lac and Lip peak could be seen in some tumors, including necrotic area of high - grade gliomas and metastases. Of 19 meningiomas, 4 showed Ala. Conclusion ^1H - MRS is a powerful unhurtable method for the study of metabolism of brain tumor in the level of microcosmic and is very helpful for the diagnosis and differentiation of brain tumors and evaluating the histologic grading, postoperative recurrence and therapy.

关 键 词：磁共振波谱学 化学位移成像 脑肿瘤 代谢产物 

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]