孤立脑转移瘤与高级别脑胶质瘤瘤周组织区氢质子磁共振波谱的意义  

Significance of 1H-MRS in peritumoral areas of brain high-grade gliomas and solitary metastasis

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

机构地区：[1]中南大学湘雅医院放射科,湖南长沙410008

出　　处：《中国医学工程》2007年第9期712-714,共3页China Medical Engineering

摘　　要：目的探讨瘤周1H-MRS鉴别高级别脑胶质瘤与孤立脑转移瘤的临床应用价值。方法高级别脑胶质瘤(Ⅲ、Ⅳ级脑胶质瘤)25例,孤立脑转移瘤20例。波谱均在非增强扫描的基础上获得,使用2D-CSI自动MR波谱检测技术,点分辨波谱序列,检测瘤周组织区和对侧正常脑组织对照区NAA、Cho和Cr的变化,并计算NAA/Cho、NAA/Cr和Cho/Cr的比值。1H-MRS所得数据的多个样本间进行两两比较采用q检验,两样本间的两两比较采用t检验。结果高级别脑胶质瘤的瘤周组织与对侧正常脑组织的NAA/Cr、Cho/Cr和NAA/Cho比值差异存在显著性(P<0.05);孤立脑转移瘤瘤周组织与对侧正常脑组织的NAA/Cr和NAA/Cho比值差异存在显著性(P<0.01),但瘤周组织与对侧正常脑组织的Cho/Cr比值差异无显著性(P>0.05);高级别脑胶质瘤和孤立脑转移瘤的瘤周组织的Cho/Cr比值差异存在显著性(P<0.05);但NAA/Cr和NAA/Cho比值差异无显著性(P>0.05)。结论孤立脑转移瘤和高级别脑胶质瘤瘤周组织间Cho/Cr比值的差异可作为1H-MRS鉴别高级别脑胶质瘤和孤立脑转移瘤的依据。[Objective] To explore the clinical worthiness of 1↑H-MRS in peritumoral areas in differentiation of High-grade gliomas and solitary metastasis. [Methods] 25 patients of high-grade gliomas（grade Ⅲ, grade IV） and 20 patients of solitary metastasi were studied. All of them underwent surgery and were approved by pathology. The 25 patients of high-grade gliomas and 20 patients of solitary metastasis underwent MRI and 1↑H-MRS before surgery. All 1↑H-MRS were gained on plain MRI scan. 2D-CSI automatism proton magnetic resonance spectroscopy was performed on a 1.ST MR scanner using pointed- resolved surface coil spectroscopy （PRESS）, the variety of metabolite peaks including NAA, Cho and Cr were detected in different areas including peritumoral areas and the normal brain, and the ratio of NAA/Cho, NAA/Cr and Cho/Cr were computed. Student-Newman-Keuls-q test was used for multiple comparison and two-sample t-test was used for independent samples of the findings of 1↑H-MRS. [Results] Significant differences between peritumoral areas and the normal brain of high-grade gliomas were found in the ratios of NAA/Cr, Cho/Cr and NAA/Cho （P 〈0.05）. Significant differences between peritumoral areas and the normal brain of 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 between peritumoral areas and the normal brain of solitary metastasis （P 〉0.05）. Significant differences between peritumoral 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 ] Significant differences between peritumoral areas of High-grade gliomas and solitary metastasis are found in the ratios of Cho/Cr.

关 键 词：神经胶质瘤 转移瘤 脑肿瘤 氢质子磁共振波谱 磁共振成像 

分 类 号：R739.41[医药卫生—肿瘤]