^1H-MRS在检测胶质瘤早期放疗反应中的应用  

Application of ~1H-MRS in detecting early radiotherapy response in glioma

作　　者：孙珊珊[1] 刘宏[1] 董文艳[1] 姜政[2] 王建波[1] 谭炳煦[1] 王庆伟[1] 

机构地区：[1]山东大学齐鲁医院肿瘤中心放疗科,济南250012 [2]山东大学齐鲁医院神经外科,济南250012

出　　处：《山东大学学报（医学版）》2012年第4期51-55,共5页Journal of Shandong University:Health Sciences

基　　金：山东省科技发展计划项目(2007GG30002017)

摘　　要：目的观察大鼠C6胶质瘤模型放疗前后氢质子磁共振波谱(1H-MRS)表现,探讨其在早期监测肿瘤治疗反应中的作用。方法建立SD大鼠C6胶质瘤模型,分为照射组(n=10)和未照射组(n=12),建模后第9天给予照射组荷瘤鼠单次大剂量外照射(15 Gy/次/野)。两组大鼠建模后均接受1H-MRS扫描,选择N-乙酰天冬氨酸(NAA)、胆碱(Cho)、乳酸(Lac)为检测肿瘤组织代谢的指标,同时行磁共振扫描(MRI)检测肿瘤体积的变化;连续观察建模后两组代谢物及体积变化,并对两组代谢指标变化与肿瘤体积变化行相关性分析。结果所有大鼠均成功种植肿瘤;未照射组随肿瘤体积增大,Cho、Lac浓度增加,NAA浓度减小,代谢物变化与体积变化呈显著相关性(Cho:r=0.958,P<0.001;Lac:r=0.989,P<0.001;NAA:r=-0.943,P<0.001);照射组放疗后1 d,Cho由3.37 mmol/kg降至2.0 mmol/kg(P<0.01)。放疗后3 d,Lac由2.34 mmol/kg降至1.59 mmol/kg(P<0.01),NAA较治疗前无显著改变(P>0.05),放疗后3 d肿瘤体积较治疗前增加31.4%(P<0.01),放疗后5 d体积开始减小,随后出现肿瘤生长抑制,各代谢指标继续下降且与体积变化呈相关趋势(Cho:r=0.696,P=0.304;Lac:r=0.911,P=0.089;NAA:r=-0.583,P=0.417),MRI检测的体积发生变化之前,1H-MRS检测的代谢物已经出现抑制性变化。结论1H-MRS可无创性获得胶质瘤放疗前后代谢物NAA、Cho、Lac变化信息,较早监测早期治疗反应,敏感性优于MRI,是一种有效的判断近期疗效的检查方法。Objective To observe the 1H-MRS of C6 glioma models before and after radiotherapy,and to discuss its effect in detecting early response in oncotherapy.Methods C6 glioma models of SD rats（treated group,n=10;untreated group,n=12）were applied and a single dose of 15 Gy was given to the treated group 9 days after tumor implantation.After tumor implantation,1H-MRS was used to detect changes in tumor metabolism,such as N-Acetyl-L-aspartic acid（NAA）,Choline（Cho） and Lactic acid（Lac）.MRI was used to detect changes of tumor volume.Changes of metabolism and volume in the two groups were observed and correlation analysis was done for indices changes and tumor size changes of the two groups.Results Rate of tumor formation was 100% in all rats.In the untreated group（n=12）,Cho and Lac showed an ascendant trend and NAA gradually decreased with tumor growth.Changes of tumor metabolites and tumor volume had significant correlations（Cho： r=0.958,P0.001;Lac： r=0.989,P0.001;NAA： r=-0.943,P0.001）.In the treated group（n=10）,Cho decreased from 3.37 mmol/kg to 2.0 mmol/kg（P0.01） 1 day after radiation,Lac decreased from 2.34 mmol/kg to 1.59 mmol/kg（P0.01） 3 days after radiation and there was no significant change in NAA（P0.05）.Tumor volume increased 31.4%（P0.01） at 3rd day and began to shrink at 5th day after radiation,and then tumor growth inhibition appeared,the metabolic indices continued to fall and there was a correlation trend between tumor volume changes and metabolic indices（Cho： r=0.696,P=0.304;Lac： r=0.911,P0.089;NAA： r=-0.583,P0.417）.Before volume changes detected by MRI began,inhibitive changes in metabolites detected by 1H-MRS had already happened.Conclusion 1H-MRS can detect metabolism changes of glioma such as NAA,Cho and Lac before and after noninvasive radiotherapy.It is more sensitive in monitoring early response to radiation than MRI and is an effective method in determining the short-term effect of treatments.

关 键 词：C6胶质瘤模型 1H-MRS 放射疗法 SD大鼠 

分 类 号：R73-3[医药卫生—肿瘤]