1H—MRS在脑胶质瘤诊断及分级中的应用  

Application of 1H-MRS in diagnosis and pathological grading of brain gliomas

作　　者：纪邦启[1] 宋磊[2] 刘斌[3] 

机构地区：[1]济南钢铁集团总公司总医院放射科,山东济南250101 [2]山东大学第二医院,山东济南250033 [3]山东中医药大学,山东济南250355

出　　处：《中国中西医结合影像学杂志》2008年第4期247-250,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:分析脑胶质瘤的氢质子磁共振波谱(proton magnetic resonance spectroscopy,1H-MRS)表现及其临床意义;探讨脑胶质瘤的1H-MRS特点与其病理级别相关性。方法:搜集经临床手术、病理证实的脑胶质瘤38例,按照WHO分级(2000)标准分成两组:低级别脑胶质瘤组、高级别脑胶质瘤组。所有患者在术前行1H-MRS检查,均在MR非增强成像的基础上获得。使用GE Signa1.5T超导磁共振扫描仪,多体素扫描,点分辨选择波谱法,检测不同区域代谢物变化。结果:脑胶质瘤的1H-MRS表现:肌酸(Cr)无明显变化;N-乙酰天门冬氨酸(NAA)下降,胆碱(Cho)增高,变化的程度由肿瘤级别高低决定;低级别、高级别脑胶质瘤的肿瘤组织分别和对侧正常脑组织的NAA/Cr、Cho/Cr、NAA/Cho比值存在显著性差异(P<0.01);低级别脑胶质瘤和高级别脑胶质瘤的肿瘤组织的NAA/Cr、Cho/Cr、NAA/Cho比值有统计学意义(P<0.05),脑胶质瘤的NAA/Cho、Cho/Cr、NAA/Cr比值与病理级别相关。结论:1H-MRS与MRI相结合能提高脑胶质瘤术前诊断的准确性。1H-MRS可评价脑胶质瘤的分级,反映脑胶质瘤代谢特性以及肿瘤生长潜能。Objective： To evaluate the findings and clinical significance of 1H-MRS,and to explore the correlation between the findings of 1H-MRS and the pathological grading of gliomas. Methods： Thirty-eight patients of gliomas approved by pathology were reviewed,all cases were categorized into two groups （low grade gliomas and high grade gliomas） according to WHO diag nostic criteria. The 38 patients underwent 1H-MRS before surgery on plain MRI scanning. Multiple voxel proton magnetic resonance spectroscopy was performed on a 1.5T MR scanner using point resolved selective spectroscopy （PRESS）, the variety of metabolite peaks were detected in different areas. Results： The Cr peak of the gliomas was normal, while the NAA peak decreased and the Cho peak increased. Significant differences between low/high grade gliomas and normal tissue in contralateral brain hemispheres were found in the ratios of NAA/Cr,Cho/Cr and NAA/Cho（ P 〈0.01）. Statistic differences between low grade gliomas and high grade gliomas were found in the ratios of NAA/Cr,Cho/Cr and NAA/Cho （ P 〈0.05）. There was significant correlation between the ratios of NAA/Cr,Cho/Cr and NAA/Cho and the pathological grading of gliomas. Conclusion： The combination of 1H-MRS and MRI improves preoperative diagnostic accuracy of gliomas,1H-MRS has made it possible to evaluate the grade of gliomas,obtain metabolic information of gliomas and reflect the potential growth of tumor.

关 键 词：脑胶质瘤 氢质子磁共振波谱 磁共振成像 代谢 

分 类 号：R739.4[医药卫生—肿瘤]