骨和软组织肿瘤的3．0T磁共振磷谱变化研究  

Changes of 3-tesla 34P-MR spectroscopy of bone and soft tissue tumors

作　　者：齐滋华[1] 李传福[1] 马祥兴[1] 李振峰[2] 张凯[1] 于德新[1] 

机构地区：[1]山东大学齐鲁医院放射科,济南250012 [2]山东大学齐鲁医院骨科,济南250012

出　　处：《中华肿瘤杂志》2009年第6期442-446,共5页Chinese Journal of Oncology

摘　　要：目的探讨骨和软组织肿瘤磁共振磷谱（34P—MRS）的变化特点。方法对41例经病理证实的骨和软组织肿瘤患者的18个良性肿瘤病灶、28个恶性肿瘤病灶及其相邻部位正常肌肉组织，应用3．0TMR机进行34P—MRS分析，测量波谱中磷酸单酯（PME）、无机磷（Pi）、磷酸二酯（PDE）、磷酸肌酸（Pcr）、三磷酸腺苷γ-峰（γ-ATP）、α-峰（α—ATP）和β-峰（β—ATP）的峰下面积。分别以β—ATP、三磷酸核苷（NTP）和Pcr为参照，计算各代谢产物的相对比值。根据H相对于Pcr化学位移的变化计算细胞内pH值。结果良、恶性肿瘤组中Pcr／PME、PME／NTP与正常对照组比较，差异均有统计学意义（P〈0．05）。良、恶性肿瘤组中PME／β-ATP与PME／NTP比较，差异有统计学意义（p〈0．05）。结论Pcr／PME和PME／NTP是诊断骨和软组织肿瘤的潜在指标，PME／β-ATP和PME／NTP是鉴别骨和软组织肿瘤良、恶性的潜在指标。Objective To study the characteristic changes of 3z P-MR spectroscopy of bone and soft tissue tumors. Methods 41 patients were examined by phosphorus surface coil of 3 tesla MR machine, including 18 benign tumor foci and 28 malignant foci, and adjacent normal muscles. The areas under the peaks of various metabolites in the spectra were measured, including phosphomonoester （ PME ）, inorganic phosphours （Pi） , phosphodiester （PDE） , phosphocreatine （Pcr） , adenosine triphosphate （ ATP ） γ,α,β. The ratios of the metabolites to β-ATP, NTP and Pcr were calculated. Intracellular pH was calculated according to the chemical shift change of Pi relative to Pcr. Results The ratios of Pcr/PME and PME/NTP in benign and malignant tumor groups were significantly different from those of the normal group （ P 〈 0.05）. Between benign and malignant tumor groups, the ratios of PME/β-ATP and PME/NTP were significantly different （P 〈0. 05）. Conclusion Pcr/PME and PME/NTP are potential diagnostic indexes of bone and soft tissue tumors. PME/β-ATP and PME/NTP are potential indexes of differential diagnosis of bone and soft tissue tumors.

关 键 词：骨肿瘤 软组织肿瘤 磁共振波谱学 诊断 鉴别诊断 

分 类 号：R686[医药卫生—骨科学]