^1H—MRS在脑膜瘤诊断及各亚型分型中的应用  

The application of 1H-MRS in diagnosis of meningiomas and its subtypes

作　　者：王永奇[1] 殷玉梅[2] 孟凡莲[1] 栾慧[3] 于秀荣[1] 

机构地区：[1]潍坊市人民医院放射科,山东潍坊261041 [2]潍坊市中医院影像科 [3]潍坊医学院

出　　处：《实用放射学杂志》2011年第10期1469-1472,共4页Journal of Practical Radiology

摘　　要：目的分析脑膜瘤各亚型的氢质子磁共振波谱（^1H—MRs）表现以及其临床意义。方法病理证实的脑膜瘤72例，按照WHO标准分为4类，其中良性脑膜瘤55例，包括纤维型30例，脑膜内皮型12例，沙粒体型13例；间变型脑膜瘤（恶性脑膜瘤）17例。采用多体素扫描，点分辨选择波谱法，检测瘤区代谢物变化。检测N-乙酰天门冬氨酸（NAA）、胆碱（Cho）、肌酸与磷酸肌酸之和（Cr＋PCr，简称Cr）的相对浓度，并计算NAA／Or、Cho／Cr、NAA／Cho比值，以病理结果进行分组对照研究。结果良性与恶性脑膜瘤相比，Cho浓度、Cho／Cr较低，而cr浓度较恶性脑膜瘤为高。良性脑膜瘤3个亚型间NAA及Cho均无届著性差异；脑膜内皮型与纤维型及沙粒体型的NAA／Cr、Cr浓度有显著性差异；纤维型与沙粒体型的NAA／Cho、Cho／Cr间有显著性差异；脑膜内皮型与沙粒体型的NAA／Cho、脑膜内皮型与纤维型的Cho／Cr间有显著性差异。结论’HMRS在脑膜瘤各亚型中代谢产物有其特异性，对各病理亚型有鉴别作用，与常规MRI相结合能提高脑膜瘤的诊断水平。Objective To analysed proton magnetic resonance spectroscopy（1H-MRS）findings and its cilinical significance of meningiomas. Methods 72 patients with meningiomas proved surgically and pathologically were studied,including four types according to WHO classification fibrous type in 30 cases, meningothelial type in 12 cases, psammomatous type in 13 cases and malignant meningioma in 17 cases. All patients underwent conventional MRI and multiple voxel MRS before operation at 1.5T MR scanner using point resolved selective spectroscopy,the variety of metabolite peaks were detected of the tumors. Results MRS showed that Cho and the ratio of Cho/Cr（Cr/PCr） decreased and Cr increased in benign meningiomas as compared to malignant one. The metabolites, such as NAA and Cho were not of differences between subtpes of benign meningiomas. There were significant differences in NAA/Cr and Cr among fibrous type, meningothelial type and psammomatous type,in Cho/Cr and NAA/Cho between fibrous type and psammomatous type,in NAA/Cho between meningothelial type and psammomatous type, in Cho/Cr between meningothelial type and fibrous type. Conclusion 1H-MRS plays an important role in differentiating the subtypes of meningiomas. The combination of 1HMRS and conventional MRI can improve the ability of diagnosis for meningiomas.

关 键 词：脑 氢质子磁共振波谱 脑膜瘤 

分 类 号：R739.45[医药卫生—肿瘤] R445.2[医药卫生—临床医学]