多体素1H-MRS在脑胶质瘤与脑脓肿鉴别诊断中的应用  

Role of 1 H-MRS in differential diagnosis of gliomas and brain abscess

作　　者：闫俊荣[1] 沈加林[1] 许建荣[1] 路青[1] 邱永明[1] 

机构地区：[1]上海交通大学医学院附属仁济医院影像科,上海200127

出　　处：《实用放射学杂志》2011年第12期1791-1794,共4页Journal of Practical Radiology

基　　金：多学科联合脑胶质瘤的诊断和治疗（RJ-4101307）;上海市重点学科建设资助项目（S30203）.

摘　　要：目的 评价多体素MRS在脑胶质瘤与脑脓肿诊断和鉴别诊断中的应用价值.方法 收集16例脑内占位病例,10例胶质瘤（Ⅲ-Ⅳ级7例,Ⅱ级3例,按照WHO分级标准,均经手术病理证实）、6例脑炎脑脓肿（均经手术病理或穿刺活检证实）,所有患者均行MRI常规检查和多体素MRS检查.测量病灶区及对侧正常区的Cho、Cho/NAA,并计算Cho-norm（标准化Cho：病灶区Cho/正常对侧区Cho）.结果 10例胶质瘤瘤体Cho/NAA高于对侧正常区,差异有统计学意义;6例脑炎脑脓肿病灶Cho/NAA高于对侧正常区,差异有统计学意义;胶质瘤瘤体Cho/NAA高于脑炎脑脓肿病灶区,然而P＞0.05,差异无统计学意义;胶质瘤瘤体Cho-norm高于脑炎脑脓肿病灶区,差异有统计学意义.结论 多体素MRS中Cho-norm能够帮助鉴别脑胶质瘤及脑炎脑脓肿,从而制订最佳治疗方案.Objective To evaluate the diagnostic value of ^1H magnetic resonance spectroscopy （1H-MRS） in differentiating gliomas from brain abscess. Methods sixteen patients with intracranial masses including 10 cases with glinmas（grade II in 3 and grade Ⅲ-Ⅳ in 7） and 6 cases with abscesses confirmed pathologically underwent MR imaging and proton MR spectroscopy. MR spectroscopic parmeters were evaluated at the lesions and apposite sides. Results Cho/NAA of glioma（n= 10） was higher than that of collateral normal tissues,Cho/NAA of abscesses （n=6） was higer than that of opposite normal tissues. Cho/NAA was no of signifi cant difference between gliomas and brain abscesses; significant differences were found in the ratios of Cho-norm between gliomas and brain abscesses （ P〈0.05 ）. Conclusion MR spectroscopy can improve the diagnostic accuracy in differentiating gliomas from brain abscesses.

关 键 词：脑 胶质瘤 磁共振波谱 脑脓肿 

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