氢质子磁共振波谱鉴别孤立脑转移瘤与高级别脑胶质瘤的临床应用价值  

Clinical Applied Value of ~1H-MRS in the Differentiation of Solitary Metastasis and Brain High-grade Gliomas

作　　者：周高峰[1] 王小宜[1] 廖伟华[1] 王润文[1] 龚才桂[1] 贾高志[1] 

机构地区：[1]中南大学湘雅医院放射科,湖南长沙410008

出　　处：《实用放射学杂志》2007年第1期1-5,共5页Journal of Practical Radiology

基　　金：国家自然科学基金资助项目分课题(编号:30370433)。

摘　　要：目的探讨孤立脑转移瘤与高级别脑胶质瘤的MRI、1H-MRS的临床应用价值。方法经手术病理证实的高级别脑胶质瘤(Ⅲ、Ⅳ级脑胶质瘤)25例及孤立脑转移瘤20例,术前均行常规MRI及1H-MRS检查。从病变部位、信号强度、水肿程度、强化形态及出血与否等方面评价孤立脑转移瘤和高级别脑胶质瘤的常规MRI表现;检测肿瘤组织、瘤周组织区和对侧正常脑组织对照区NAA、Cho和Cr的变化,计算出NAA/Cho、NAA/Cr和Cho/Cr的比值。结果(1)孤立脑转移瘤和高级别脑胶质瘤的常规MRI各种表现中仅病变部位和水肿程度在两者间存在差别,P值分别为0.009、0.046;(2)高级别脑胶质瘤和孤立脑转移瘤的肿瘤组织的NAA/Cr和NAA/Cho比值存在显著性差异(P<0.01),但Cho/Cr比值无显著性差异(P>0.05);(3)高级别脑胶质瘤和孤立脑转移瘤的瘤周组织的Cho/Cr比值存在显著性差异(P<0.05),但NAA/Cr和NAA/Cho比值无显著性差异(P>0.05)。结论常规MRI结合1H-MRS表现可望提高鉴别高级别脑胶质瘤和孤立脑转移瘤的可能性。Objective To explore the clinical applied value of ^1H - MRS in the differentiation of high - grade gliomas and solitary metastasis. Methods 25 patients with high - grade gliomas （ grade Ⅲ, grade Ⅳ） and 20 patients with solitary metastasis proved by pathology underwent MRI and ^1H - MRS examination before surgery . MRI findings of high - grade gliomas and solitary metastasis were evaluated according to the location , signal intensity , extent of edema , bleeding and the state of contrast enhancement of the lesions . The mctabolitcs including NAA,Cho and Cr were detected in different areas including tumors and pcritumoral areas and the normal brain , the ratios of NAA/Cho , NAA/Cr and Cho/Cr were also computed. Results （ 1 ） In the location and edema extent of lesions on MRI was significantly different between high - grade gliomas and solitary metastasis （ P = 0. 009,0. 046 ） ; （ 2 ） Significant differences between tumors of high - grade gliomas and solitary metastasis were found in the ratios of NAA/Cr and NAA/Cho （ P 〈 0.01 ） , but no significant differences were found in the ratios of Cho/Cr（ P 〉 0.05 ） ; （ 3 ） Significant differences between pcritumoral areas of high - grade gliomas and solitary metastasis were found in the ratios of Cho/Cr（ P 〈 0.05 ） , but no significant differences were found in the ratios of NAA/Cr and NAA/Cho（ P 〉 0.05 ）. Conclusion The combination of routine MRI and ^1 H - MRS is expected to improve the possibility in distinguishing the high - grade gliomas and solitary metastasis.

关 键 词：脑 胶质瘤 转移瘤 氢质子磁共振波谱分析 磁共振成像 

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