^1H-MRS在颅内胶质瘤分级中的应用价值  

The value of ^1H-MRS in cerebral glioma

作　　者：贺丹[1] 杨丽[1] 朱青峰[1] 刘怀军[1] 傅方望[1] 张玉笛[1] 刘宗杰[1] 李艳华[1] 

机构地区：[1]河北医科大学第二医院,河北石家庄050000

出　　处：《中国临床医学影像杂志》2011年第2期77-82,共6页Journal of China Clinic Medical Imaging

摘　　要：目的:探讨3.0T磁共振氢质子波谱(1H-MRS)相对定量分析对颅内胶质瘤术前分级的临床应用价值。方法:应用GE 3.0T磁共振系统,对32例经病理证实的胶质瘤患者进行1H-MRS检查,观察肿瘤实质区、瘤周水肿区及对侧正常区1H-MRS谱线表现,定量分析各种代谢物Cho/Cr、NAA/Cr、Cho/NAA、Cho/nCho、Lac/Cr比值变化,并与病理结果相对照。另设11例为正常对照组。结果:胶质瘤肿瘤实质区和正常对照组脑组织Cho/Cr、NAA/Cr、Cho/NAA(分别为2.10±1.04,0.84±0.44,2.05±0.70和0.87±0.13,1.43±0.14,0.61±0.10)存在显著性差异(P<0.05)。低、高级别胶质瘤肿瘤实质区Cho/Cr、NAA/Cr、Cho/NAA、Cho/nCho、Lac/Cr比值(分别为1.58±0.63,0.96±0.57,1.74±0.61,1.04±0.81,1.58±0.10和2.62±1.45,0.78±0.31,3.35±0.89,2.14±1.77,2.61±2.75)存在显著性差异(P<0.05)。低、高级别胶质瘤瘤周水肿区Cho/Cr、NAA/Cr、Cho/NAA、Cho/nCho比值(分别为1.43±0.32,0.82±0.45,1.22±0.19,1.23±0.36和2.21±0.49,1.12±0.23,2.09±0.82,1.47±1.13)亦存在显著性差异(P<0.05)。肿瘤实质区Cho/Cr、Cho/NAA、Cho/nCho、Lac/Cr比值与肿瘤的级别呈正相关(r=0.42,0.62,0.41,0.26),NAA/Cr与肿瘤级别呈负相关(r=-0.35),Cho/NAA与肿瘤级别的相关系数绝对值最大(r=0.62),相关性最高。结论:1H-MRS可为术前确定胶质瘤级别提供诊断依据,具有重要临床应用价值。Objective： To approach the clinical application value of correspondance quantitative analysis with 3.0T magnetic resonance spectroscopy（1H-MRS） in grading cerebral glioma before operation.Methods： Thirty-two patients with cerebral glioma confirmed by pathological results were performed with 1H-MRS on GE 3.0T magnetic resonance system.The spectral line in the solid area of tumour,peritumor edematous area and normal-area of the opposite side were observed with 1H-MRS.Cho/Cr,NAA/Cr,Cho/NAA,Cho/nCho,Lac/Cr were analyzed.The results of 1H-MRS were compared with the results of pathology.Another 11 subjects were normal control.Results： There were significant differences in Cho/Cr,NAA/Cr,Cho/NAA between solid area of glioma and normal area of the opposite side（2.10±1.04,0.84±0.44,2.05±0.70 and 0.87±0.13,1.43±0.14,0.61±0.10 respectively）.There were significant differences in Cho/Cr,NAA/Cr,Cho/NAA,Cho/nCho,Lac/Cr between solid area in the low grade glioma group and that in the high grade glioma group that is（1.58±0.63,0.96±0.57,1.74±0.61,1.04±0.81,1.58±0.10 and 2.62±1.45,0.78±0.31,3.35±0.89,2.14±1.77,2.61±2.75 respectively）（P0.05）.There were also significant differences in Cho/Cr,NAA/Cr,Cho/NAA,Cho/nCho（i.e.1.43±0.32,0.82±0.45,1.22±0.19,1.23±0.36 and 2.21±0.49,1.12±0.23,2.09±0.82,1.47±1.13） between edematous area in the low grade glioma group and that in the high grade glioma group（P0.05）.Cho/Cr,Cho/NAA,Cho/nCho,Lac/Cr（r=0.42,0.62,0.41,0.26） of solid area of tumor was of positive correlation with the grade of tumor,and NAA/Cr（r=-0.35） was of negative corretation.The correlative coefficient of Cho/NAA（r=0.62） was the maximum and had maximal dependability with grade of tumor.Conclusion： 1H-MRS had very important clinical application value in providing diagnostic support for grading of cerebral glioma before operation.

关 键 词：神经胶质瘤 磁共振波谱学 

分 类 号：R739.41[医药卫生—肿瘤] R730.264[医药卫生—临床医学]