磁共振波谱在脑内肿瘤鉴别诊断中的价值研究  

Magnetic resonance spectroscopy in differential diagnosis of brain tumor

作　　者：杨纶先[1] 胡波[1] 陈永严[1] 胡新华[1] 邹元杰[1] 马骏[1] 章文斌[1] 张锐[1] 刘宏毅[1] 常义[1] 

机构地区：[1]南京医科大学附属脑科医院神经外科,210029

出　　处：《临床神经外科杂志》2010年第1期28-29,32,共3页Journal of Clinical Neurosurgery

基　　金：南京市科技局基金项目(200702076)

摘　　要：目的探讨磁共振波谱(MRS)在脑内肿瘤鉴别诊断中的应用价值。方法收集75例颅内占位性病变患者术前行磁共振波谱检查的临床资料,对其经临床手术、病理诊断证实的最终结果进行分析。结果 MRS提示肿瘤72例,病理证实70例;脑脓肿1例,病理证实1例;MRS提示囊性占位2例。胶质瘤的MRS表现为NAA明显降低或降低,Cho升高,肿瘤周围脑组织呈类似改变;脑膜瘤的MRS表现为NAA消失或降低,Cho升高或明显升高,Cr信号降低,可见到Ala峰,肿瘤周围脑组织相对正常;转移瘤的MRS表现为Cho明显升高,NAA明显降低,而瘤旁脑组织MRS波形基本正常;淋巴瘤的MRS表现为肿瘤区域NAA降低,Cho升高或明显升高,并可见到Lip峰。结论 MRS作为无创性的检测手段,对脑内肿瘤的鉴别诊断有较大的参考价值。Objective To study the value of proton magnetic resonance spectroscopy （ 1 H-MRS） in the diagnosis and differential diagnosis of brain tumor. Methods MRI and 1H-MRS findings as well as clinical data of 75 cases with different intracranial lesions confirmed surgically and pathologically were retrospectively analyzed. Results 1H-MRS showed that there is significant decreased NAA ratio and increased Cho ratio in gliomas compared to normal brain tissues, the peritumoral area were similar with gliomas, but the range of decreas or increas was slight. Meningiomas： NAA disappeared or decreased and Cho obviously increased, Cr decreased and Ala presented, but the peritumoral area were normal. Metastasis： NAA decreased and Cho obviously increased, but the peritumoral area were roughly normal. Lymphoma： NAA decreased and Cho obviously increased, Lip presented. Conclusion： 1H-MRS can be used as a supplementary nontraumatic method was significant value in their diagnosis and differential diagnosis of brain tumor .

关 键 词：磁共振波谱(MRS) 脑肿瘤 鉴别诊断 

分 类 号：R455.2[医药卫生—运动医学] R739.41[医药卫生—治疗学]