多体素磁共振氢质子波谱在脑胶质瘤诊断及分级中的初步应用研究  

Evaluation of cerebral glioma grade by using multivoxel 3D proton MR spectroscopy

作　　者：任静[1] 周鹏[1] 左佳明[1] 刘锦[1] 王闽[1] 杨宇洁[1] 陈锦秀[1] 许国辉[1] 

机构地区：[1]四川省肿瘤医院影像科,四川成都610041

出　　处：《四川医学》2011年第6期793-796,共4页Sichuan Medical Journal

基　　金：四川省卫生厅课题(编号:070025)

摘　　要：目的探讨3D多体素1H-MRS代谢物改变、并结合形态学改变在脑胶质瘤诊断及分级中的价值。方法选取51例脑胶质瘤患者,所有患者均行开颅手术,病理证实低级16例、Ⅱ级部分区域间变呈Ⅲ级4例,高级31例;所有患者均行颅脑常规核磁共振增强扫描和3D多体素135ms序列扫描。分别测定病变实质、病变周围区域的胆碱(Cho)、肌酸(Cr)、乙酰天门冬氨酸(NAA)、Cho/NAA、Cho/Cr、NAA/Cr比值的变化;对结果进行统计学分析。结果体素内Cho升高提示肿瘤增生活跃、NAA减低提示神经元破坏程度。低级别胶质瘤和高级别胶质瘤瘤体区Cho/Cr、Cho/NAA比值比较差异有统计学意义(P<0.05)。结论多体素1H-MRS结合形态学改变在脑胶质瘤诊断、分级及鉴别诊断中有重要价值;1 H-MRS代谢物改变较敏感,与体素内所包含组织密切相关,在分析代谢物变化时应结合相应区域形态学改变。Objective To determine whether metabolite ratios in multivoxel3D proton MR spectroscopy（^1H-MRS） is dif-ferent between low-grade and high-grade gliomas and may be useful for diagnosis and glioma grading.Methods MR scan and 3D 1 H-MRS studies of 51 patients with histologically proven（16 low-grade,4Ⅱ-Ⅲ-grade and 31 hight-grade glimas） were retrospec-tively reviewde.Metabolite Cho,Cr,NAA and metabolite ratios Cho/NAA Cho/Cr,NAA/Cr were measured.The metabolite ratios（Cho/NAA,Cho/Cr,NAA/Cr） of low and high-grade gliomas were statistically analyzed.Results The Cho within voxel increased means the tumor proliferation activity.The NAA within voxel reduced means neuronal damaged.The metabolite ratios（Cho/NAA,Cho/Cr,NAA/Cr） of low and high-grade gliomas was significant difference（P〈0.05）.Conclusion Metabolite ratios of low-grade gliomas were significantly different from high-grade gliomas.^1H-MRS combined with morphological changes could be useful in gliomas diagnosis and differential diagnosis and grading.^1H-MRS metabolite changes were sensitive,and is closely related to contained tissue within voxel.Analysis of metabolites changes should be combined with the corresponding region of morphological changes.

关 键 词：肿瘤 神经上皮 磁共振波谱 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]