孤立脑转移瘤氢质子磁共振波谱的临床应用  

The Clinic Application of 1H-MRS of Solitary Metastasis

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

机构地区：[1]中南大学湘雅医院放射科,长沙410008

出　　处：《临床放射学杂志》2007年第8期760-763,共4页Journal of Clinical Radiology

基　　金：国家自然科学基金资助项目分课题(基金编号:30370433)

摘　　要：目的探讨孤立脑转移瘤氢质子磁共振波谱(1H-MRS)表现及临床价值。资料与方法35例术前均行常规MRI及1H-MRS检查。波谱均在非增强扫描的基础上获得,使用二维化学位移(2D-CSI)自动MR波谱检测技术,点分辨波谱序列,检测肿瘤组织、瘤周组织区和对侧正常脑组织对照区氮-乙酰天门冬氨酸(NAA)、胆碱(Cho)和肌酸(Cr)的变化,并计算NAA/Cho、NAA/Cr和Cho/Cr的比值。1H-MRS所得数据的比较采用t检验。结果(1)孤立脑转移瘤肿瘤组织表现为:无或极低的NAA峰,NAA下降率为-94.1%,Cr下降率为-52.2%,Cho上升率为68.5%。(2)肿瘤组织与瘤周组织、肿瘤组织与对侧正常脑组织、瘤周组织与对侧正常脑组织的NAA/Cr和NAA/Cho比值差异有统计学意义(P<0.01);(3)肿瘤组织分别与瘤周组织、对侧正常脑组织的Cho/Cr比值差异有统计学意义(P<0.01),但瘤周组织与对侧正常脑组织的Cho/Cr比值差异无统计学意义(P>0.05)。结论孤立脑转移瘤的1H-MRS表现有一定特征,1H-MRS与MRI相结合可望提高孤立脑转移瘤术前诊断的准确性。Objective To evaluate the findings of 1^H-MRS of solitary metastasis and its clinic value. Materials and Methods 35 patients of solitary metastasis performed with conventional MR and 1^H MRS. All 1^H -MRS were obtained on plain MRI scan. 2D-CSI automatism proton magnetic resonance spectroscopy was performed on a 1.5T MR scanner using pointed-resolved surface coil spectroscopy（ PRESS）, the variety of metabelite peaks including NAA, Cho and Cr were detected in different areas including tumors, peritumoral areas and the normal brain, and the ratio of NAA/Cho,NAA/Cr and Cho/Cr were computed, two-sample t-test was used for the findings of 1^H -MRS. Results 1 ） The findings of 1^H MRS of solitary metastasis were distinctly increased Cho（ ＋68.5% ）, distinctly decreased Cr（ -52.2% ）, disappeared NAA or markedly decreased NAA（ -94.1% ）.2） Significant differences between tumors and peritumoral areas , tumors and the normal brain, peritumoral areas and the normal brain of solitary metastasis were found in the ratios of NAA/Cr and NAA/ Cho （P 〈 0.01 ）. 3） Significant differences between tumors and peritumoral areas , tumors and the normal brain of solitary metastasis were found in the ratios of Cho/Cr （ P 〈0.01 ）, but no significant differences were found in the ratios of Cho/Cr between peritumoral areas and the normal brain of solitary metastasis （ P 〉 0.05 ）. Conclusion There are certain characteristics in i n -MRS of solitary metastasis. The combination of 1^ H- MRS and MRI can improve the diagnostic accuracy for solitary metastasis before operation.

关 键 词：转移瘤 脑肿瘤 氢质子磁共振波谱 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]