软组织肿瘤良恶性鉴别的术后标本~1H-MRS研究  

Differentiation of benign and malignant soft tissue tumors by ~1H-MR spectroscopy：based on surgical specimens

作　　者：胡美玉[1] 单卉[2] 赖英荣[3] 江波[1] 

机构地区：[1]中山大学第一附属医院黄埔院区放射科,广州510700 [2]中山大学第一附属医院影像科 [3]中山大学第一附属医院病理科

出　　处：《放射学实践》2010年第10期1083-1086,共4页Radiologic Practice

摘　　要：目的:探讨术后标本1H-MRS鉴别软组织肿瘤良恶性的意义。方法:29例软组织肿瘤术后新鲜标本行常规MRI及1H-MRS测量,比较良、恶性肢体软组织肿瘤在1H-MRS代谢物胆碱(Cho)、肌酸(Cr)、三甲胺(TMA)、N-乙酰天门冬胺酸(NAA)、细胞内脂质IMCL(Lip1)、细胞外脂质EMCL(Lip2)相对浓度(即代谢物峰下平均面积)及Cho/Cr、TMA/Cr、NAA/Cr、Lip1/Cr、Lip2/Cr相对浓度比值,进行差异的t检验。结果:良性软组织肿瘤共11例,各代谢物相对浓度比值之均值分别为TMA/Cr1.02±0.50,Cho/Cr0.98±0.60,NAA/Cr0.46±0.34,Lip1/Cr7.88±6.23,Lip2/Cr5.72±4.46。恶性软组织肿瘤共18例,各代谢物相对浓度比值之均值分别为TMA/Cr2.47±1.04,Cho/Cr2.02±0.72,NAA/Cr0.41±0.39,Lip1/Cr1.41±1.31、Lip2/Cr1.01±0.93。本组资料用于诊断的恶性软组织肿瘤的TMA/Cr、Cho/Cr的阈值分别为1.19和1.21,其准确度分别为96.3%和88.9%,其诊断准确性均位于较高水平。用于诊断的良性软组织肿瘤的Lip1/Cr、Lip2/Cr的阈值分别为2.03和0.82,其准确度分别为90%及80%,其诊断准确性分别位于较高及中等水平。用于诊断的良性软组织肿瘤的NAA/Cr的阈值为0.035,其准确度分别为57%,其诊断价值位于较低水平。结论:Cho/Cr、TMA/Cr、Lip1/Cr、Lip2/Cr比值可作为软组织肿瘤良、恶性程度鉴别诊断的依据。Objective：To explore the value of 1H-MRS in differentiating benign and malignant soft tissue tumors.Methods：Twenty-nine surgical specimens of the limbs and trunk were collected after operations and 1H-MRS was immediately done with surface coil.Metabolites including Choline （Cho）,Creatine （Cr）,Trimethylamine （TMA）,NAA （N-acetyl-acetate） and Cho/Cr,TMA/Cr,NAA/Cr,Lip1/Cr,Lip2/Cr were measured in the specimens,of which 11 were benign and 18 malignant pathologically.Results：The ratios of TMA/Cr,Cho/Cr,NAA/Cr,Lip1/Cr,Lip2/Cr were 1.02±0.50,0.98±0.60,0.46±0.34,7.88±6.23,5.72±4.46 in benign soft tissue tumor specimens,respectively,and 2.47±1.04,2.02±0.72,0.46±0.34,7.88±6.23,5.72±4.46 in malignant ones,respectively.The threshold values of TMA/Cr and Cho/Cr ratio for diagnosing malignant soft tissue tumors were 1.19 and 1.21, respectively.The threshold values of Lip1/Cr,Lip2/Cr ratio for diagnosing benign soft tissue tumors were 2.03 and 0.82,respectively. The threshold values of NAA/Cr ratio for diagnosing benign soft tissue tumors was 0.035, and the accuracy was 57%, which indicated low diagnostic value.Conclusion：The ratios of Cho/Cr,TMA/Cr and Lip/Cr can help differentiate benign and malignant soft tissue tumors.

关 键 词：软组织肿瘤 磁共振波谱学 诊断 鉴别 

分 类 号：R738.6[医药卫生—肿瘤] R445.2[医药卫生—临床医学]