多体素2D^1H-MRSI-解剖叠加伪彩图在胶质瘤恶性程度分级中的应用  

Multivoxel 2D ~1H-MRSI overlay anatomy imaging in grading malignancy of gliomas

作　　者：方维东[1] 罗天友[1] 吕发金[1] 李咏梅[1] 吴景全[1] 

机构地区：[1]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《第三军医大学学报》2009年第20期2019-2022,共4页Journal of Third Military Medical University

基　　金：重庆市教委科学技术研究项目(KJ080303)~~

摘　　要：目的探讨多体素2D1H-MRSI(proton magnetic resonance Spectroscopy imaging,1H-MRSI)-解剖叠加伪彩图在星形细胞胶质瘤恶性程度分级中的价值。方法对经手术切除病理证实的58例星形细胞胶质瘤的术前多体素2D1H-MRS检查资料,利用机器自带的Functool(2)spectroscopy-2DBrain分析软件,获得1H-MRSI-解剖叠加伪彩图,包括Cho、Cr、NAA、Lip或Lac代谢-解剖叠加伪彩图以及Cho/NAA和Cho/Cr相对值分布-解剖叠加伪彩图,观测这些代谢物以及相对值在瘤体内的分布情况,依据上述相对值分布-解剖叠加伪彩图,在其相对值分布最大区分别测定(Cho/NAA)max和(Cho/Cr)max。结果上述代谢物以及相对值在瘤体内分布均呈现出异质性,其中Cho/NAA、Cho/Cr以及Cho在瘤体内呈非均匀性升高,相反NAA和Cr在瘤体内呈非均匀性减低,且这种异质性在恶性程度越高胶质瘤中越明显。低度恶性与高度恶性胶质瘤的(Cho/NAA)max和(Cho/Cr)max比值存在显著差异性(P<0.01);胶质瘤的(Cho/NAA)max、(Cho/Cr)max相对值与病理级别相关,尤以(Cho/NAA)max相对值反映胶质瘤级别较稳定(相关系数rs分别为0.923、0.802)。结论多体素2D1H-MRSI-解剖叠加伪彩图能间接反映胶质瘤内部肿瘤组织的异质性,依据其所测量(Cho/NAA)max、(Cho/Cr)max在胶质瘤恶性程度评估中具有重要临床参考价值。Objective To explore the clinical value of multivoxel 2D Proton magnetic resonance spectroscopy imaging （1H-MRSI） overlay anatomy imaging in grading the malignancy of gliomas. Methods Totally 58 patients with pathologically verified gliomas were examined before operations using conventional MRI and multi-voxel 2D 1H-MRS. An attached software package Functool （2） spectroscopy-2D Brain was used to gain the 1H-MRSI overlay anatomy imaging, including the metabolic imaging＋anatomy imaging （MIDI） color overplay map of Cho, Cr, NAA and Lip or Lac, and the distribution imaging＋anatomy imaging （DIAI） color overlay map of Cho/NAA and Cho/Cr. The distributions of Cho, Cr, NAA, Lip or Lac, Cho/NAA and Cho/Cr in the lesions were observed, and the （Cho/NAA）max and （Cho/Cr）max were measured. Results Heterogeneous distribution of Cho, Cr, NAA, Lip or Lac, Cho/NAA and Cho/Cr were found in the tumor mass. Cho, and the ratios of Cho/NAA and Cho/Cr were increased heterogeneously, and NAA and Cr were decreased with heterogeneous display, especially in high-grade gliomas. A significant difference was found in the ratios of （Cho/NAA） max and （Cho/Cr）max between low-and high-grade gliomas （P0.01）. There was significantly positive correlation between the ratios of （Cho/NAA）max, and （Cho/Cr）max with the pathological grading of gliomas （rs=0.923, 0.802 respectively）. Conclusion Multivoxel 2D 1H-MRSI overlay anatomy image indirectly reflects the heterogeneous of tumor tissues, and is helpful in the grading of gliomas by （Cho/NAA）max and （Cho/Cr）max through DIAI.

关 键 词：胶质瘤 磁共振成像 氢质子磁共振波谱 

分 类 号：R730.264[医药卫生—肿瘤] R730.44[医药卫生—临床医学]