~1H-MRS引导辅助伽玛刀治疗20例脑胶质瘤的初步观察  

Preliminary observation on the effect of Gamma Knife treatment for 20 glioma patients with ~1H-MRS guidance

作　　者：姚一搏[1] 许民辉[1] 徐伦山[1] 耿明英[1] 谭勇[2] 李飞鹏[1] 沈光建[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所神经外科,重庆400042 [2]第三军医大学大坪医院野战外科研究所核磁共振室,重庆400042

出　　处：《第三军医大学学报》2012年第18期1881-1883,共3页Journal of Third Military Medical University

摘　　要：目的调查1H核磁共振波谱(1H-MRS)引导辅助伽玛刀治疗脑胶质瘤的效果。方法选择有明确病理诊断的脑胶质瘤20例,分为常规核磁共振(MRI)定位组和MRI结合核磁共振波谱(MRS)定位组,各10例。常规MRI定位组以肿瘤性增强病灶及周围短T1、长T2区为靶灶范围;MRI+MRS定位组则以肿瘤性增强病灶及周围短T1、长T2区间Cho:NAA指数(CNI)≥1.6者为靶灶范围。以伽玛刀治疗后12个月为终未观察期,统计分析两组治疗结果。结果治疗有效者13例(65%),包括常规MRI定位组6例,MRI+MRS定位组7例。10例(50%)患者发生脑水肿,包括常规MRI定位组8例,MRI+MRS定位组2例。统计分析示MRI+MRS定位组靶灶直径、脑水肿发生例数、脑水肿范围较常规MRI定位组明显下降(P<0.05)。结论伽玛刀治疗加入MRS因素有助于对脑胶质瘤甄别,减少因盲目扩大治疗范围带来的并发症。Obiective To investigate the effect of Gamma Knife treatment for glioma with 1H-magnet- ic resonance spectroscopy （MRS） guidance. Method Twenty patients with glioma confirmed by pathological diagnosis were selected and divided into a conventional MRI positioning group and a MRI ＋ MRS positioning group （n = 10）. The target area of the conventional MRI positioning group was defined as the tumorous-en- hanced focus plus the surrounding short T1 and long Tz area, and that of the MRI ＋ MRS positioning group was defined as the tumorous-enhanced focus plus the Cho： NAA index （CNI） ~〉 1.6 area in the surrounding short T1 and long T2 area. The differences of the treatment outcomes were statistically analyzed at 12 months after the Gamma Knife treatment. Results Thirteen （65 % ） of the 20 patients showed effective outcome, including 6 patients from the conventional MRI positioning group and 7 patients from the MRI ＋ MRS positioning group. Brain edema was observed in 10 patients （50%） , including 8 patents from the conventional MRI positioning group and 2 patients from the MRI ＋ MRS positioning group. The average maximum diameter of target area, the number of patients with brain edema and the range of brain edema decreased significantly in the MRI ＋ MRS po- sitioning group as compared with the conventional MRI positioning group （P 〈 0.05 ）. Conclusion Gamma Knife treatment with 1H-MRS guidance helps distinguish glioma, and can reduce the complications from the blind expansion of treatment area.

关 键 词：核磁共振波谱 伽玛刀 胶质瘤 

分 类 号：R445.2[医药卫生—影像医学与核医学] R817.5[医药卫生—诊断学]