氢质子磁共振波谱在颅内常见肿瘤诊断中的应用价值  

Application of ^1H-MRS in diagnosis of common intracranial tumors

作　　者：周宏伟[1] 孔博玉[1] 兰文婧[1] 刘洋[1] 谷艳英[1] 

机构地区：[1]吉林大学第一医院放射科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2010年第2期415-419,共5页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科技发展计划项目资助课题(200705132)

摘　　要：目的:通过氢质子磁共振波谱(1H-MRS)方法分析颅内常见肿瘤组织与正常脑组织及脑肿瘤间代谢物差别,探讨1H-MRS对颅内常见肿瘤的诊断价值。方法:对经临床手术证实的27例Ⅰ-Ⅱ级胶质瘤、22例Ⅲ-Ⅳ级胶质瘤、24例脑转移瘤和21例脑膜瘤的1H-MRS图像进行分析,得到N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱复合物(Cho)和乳酸(Lac)的峰值高度并计算NAA/Cr、Cho/Cr、NAA/Cho比值,比较各组数据。结果:颅内肿瘤常规MRI检查结果表现各异,难以鉴别;颅内肿瘤组织1H-MRS与正常脑组织比较NAA降低(P<0.01),Cho升高(P<0.05),且胶质瘤实质强化区的NAA/Cr比值与脑膜瘤、转移瘤相比具有明显差异(P<0.05)。结论:1H-MRS可以在分子水平上对颅内肿瘤进行鉴别诊断,可以在临床上弥补常规MRI影像的不足;1H-MRS检查可为病理分级、制定合理的治疗方案提供有价值的影像信息。Objective To discuss the value of 1H-MRS in diagnosis of common intracranial tumors by analyzing the metabolism differences between common intracranial tumors and normal brain tissue,and those among different intracranial tumors with 1H-MRS.Methods 1H-MRS manifestations of 27 cases of Ⅰ-Ⅱ grade glioma,22 cases of Ⅲ-Ⅳ grade glioma,24 cases of metastasis and 21 cases of meningioma were analyzed retrospectively,the peak values of N-acetylaspartate（NAA）,creatine（Cr）,choline（Cho） and lactate（Lac） were detected,the ratios of NAA/Cr,Cho/Cr,and NAA/Cho were compared.Results There were no significant differences among common intracranial tumors in routine MRI examination,and the 1H-MRS manifestations of intracranial tumors were obviously different with that of normal brain tissue：NAA was decreased（P〈0.01）,Cho was increased（P〈0.05）,and the NAA/Cr ratio in the region of glioma enhancement was obviously different with those of meningioma and metastasis（P〈0.05）.Conclusion 1H-MRS could distinguish different kinds of intracranial tumors in molecular level,so it can make up the defect of routine MRI.1H-MRS can provide useful image information in intracranial tumors for pathologic classification and regulating reasonable treatment principles.

关 键 词：磁共振波谱 化学位移成像 视野 

分 类 号：R743[医药卫生—神经病学与精神病学]