增强后多体素^1H-MRS在颅脑肿瘤诊断中的应用  

Application of Post-contrast Multivoxel ^1H-MRS in the Differential Diagnosis of Cerebral Neoplasms

作　　者：王廷昱[1] 陈晶[1] 史克珊[2] 韩向君[1] 陈旭[1] 苏文蕊[1] 

机构地区：[1]海南省海口市人民医院及中南大学湘雅医学院附属海口医院放射诊断科,570208 [2]海南省海口市人民医院及中南大学湘雅医学院附属海口医院神经外科,570208

出　　处：《临床放射学杂志》2008年第12期1646-1650,共5页Journal of Clinical Radiology

基　　金：海南省自然科学基金指导性计划项目(编号:2005-80576)

摘　　要：目的探讨增强后多体素氢质子磁共振波谱(1H-MRS)对颅内常见肿瘤的鉴别诊断价值。资料与方法49例颅内常见肿瘤患者行增强后多体素1H-MRS检查,其中胶质瘤16例,单发转移瘤19例,脑膜瘤14例。测量计算3种肿瘤强化区、强化边缘区及对侧正常脑组织的代谢物比值:胆碱/肌酸(Cho/Cr)、N-乙酰天门冬氨酸/胆碱(NAA/Cho)、胆碱/对侧正常脑组织肌酸(Cho/Cr-n)和胆碱/对侧正常脑组织胆碱(rCho),并进行比较分析。结果单发转移瘤与胶质瘤、单发转移瘤与脑膜瘤以及胶质瘤与脑膜瘤强化边缘区之间NAA/Cho比值分别为2.4434±1.636、0.4762±0.278、1.0416±0.240,Cho/Cr-n比值分别为0.5444±0.457、1.0919±0.328、1.1597±0.342,rCho比值分别为0.5405±0.497、1.1761±0.423、1.3436±0.566,Cho/Cr比值分别为0.9105±0.414、1.6208±0.230、1.0489±0.260;转移瘤与脑膜瘤间除Cho/Cr外差异均有显著统计学意义(P<0.01),胶质瘤与脑膜瘤之间除Cho/Cr(P<0.01)外差异均无统计学意义(P>0.05)。强化区之间三者NAA/Cho比值分别为0.4550±0.240、0.2436±0.220、0.1415±0.112,Cho/Cr-n比值分别为0.9149±0.294、1.5182±0.935、1.8115±0.804,rCho比值分别为0.9129±0.304、1.5426±0.808、1.7464±0.504,Cho/Cr比值分别为4.3527±2.509、3.1709±2.197、4.9518±3.716;转移瘤与胶质瘤、脑膜瘤比较除Cho/Cr外差异均有显著统计学意义(P<0.01),而胶质瘤与脑膜瘤之间差异均无统计学意义(P>0.05)。结论增强后多体素1H-MRS对脑肿瘤的鉴别诊断有重要的临床应用价值。Objective To explore the value of post contrast multivoxel^ 1H-MRS in the differential diagnosis of different intra-cranial neoplasms. Materials and Methods Post contrast muhivoxel ^1 H-MRS was performed in 49 cases with different intra-cranial neoplasms, including high grade gliomas （n = 16 ） , solitary metastases （n = 19 ） and meningioma （n = 14）. The Cho/Cr, NAA/Cho, Cho/Cr-n, rCho of enhanced region and peritumoral region and normal region in the contralatateral brain tissue were measured and compared respectively. Results The NAA/Cho in peritumoral region of the metastases, gliomas and meningioma were 2. 4434 ± 1. 636, 0. 4762 ± 0.278 and 1. 0416 ± 0. 240 respectively. The Cho/ Cr n were 0.5444 ± 0.457, 1. 0919± 0.328 and 1. 1597 ± 0.342 respectively. The rCho were 0. 5405 ± 0. 497, 1. 1761 ± 0. 423and 1. 3436 ± 0. 566 respectively. The Cho/Cr were 0.9105 ± 0. 414, 1. 6208 ± 0. 230 and 1. 0489 ± 0. 260 respectively. All the ratios had significant differences except Cho/Cr between metastases and meningioma （P 〈 0.01 ） and there was no significant differences except Cho/Cr between the gliomas and meningioma （ P 〉 0.05 ）. The NAA/Cho in enhanced region of the metastases, gliomas and meningioma were 0. 4550 ± 0. 240, 0. 2436 ± 0. 220 and 0. 1415 ± 0.112, The Cho/ Cr n were 0. 9149 ± 0. 294, 1.5182 ± 0. 935 and 1.8115 ± 0. 804. The rCho were 0.9129± 0. 304, 1. 5426 ± 0. 808 and1. 7464 ±0.504. The Cho/Cr were 4. 3527 ±2. 509, 3. 1709 ± 2. 197 and 4.9518± 3. 716. All the ratios had significant differences except Cho/Cr （P 〈 0.01 ） , but no significant difference was found between the gliomas and meningioma （P 〉 0.05）. Conclusion Post-contrast muhivoxel^ 1 H-MRS plays an important role in the differential diagnosis of different intracranial neoplasms.

关 键 词：脑肿瘤 肿瘤强化区 强化边缘区 磁共振波谱 

分 类 号：R739.4[医药卫生—肿瘤]