DWI及多体素1H—MRS在高级别胶质瘤与单发转移瘤中的鉴别诊断价值  

Differential diagnostic value of DWI and multi-voxel 1H-MRS for high-grade gliomas and single metastasis of tumor

作　　者：丁启星[1] 韩崇明 王雁冰[1] 

机构地区：[1]山东省日照市人民医院影像科,276826 [2]日照市第三人民医院

出　　处：《中国实用医刊》2012年第22期47-50,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨磁共振扩散加权成像（DWI）及多体素。H磁共振波谱分析在高级别胶质瘤与单发转移瘤中的鉴30诊断价值。方法选取经手术病理或临床确诊的18例高级别脑胶质瘤及12例单发脑转移瘤患者。采用GE公司SignaEXCITEHD3．0T超导型MR扫描仪对所有患者行颅脑常规MRI扫描、DWI及二维多体素144ms序列扫描。采用Functool软件包后处理，分别测定病变实质、病变周围及健侧相应区域的Cho／Cr、Cho／NAA、NAA／cr比值的变化，并用SPSS13.0软件对结果进行统计学分析。结果高级别胶质瘤和脑转移瘤瘤体区Cho／NAA比较差异有统计学意义（P〈0．05）；Cho／Cr、NAA／Cr比较差异无统计学意义（P〉0．05）；瘤周水肿区Cho／Cr、Cho／NAA值分别比较差异有统计学意义（P〈0．05）；NAA／Cr比较差异无统计学意义（P〉0．05）。高级别胶质瘤和脑转移瘤囊变坏死区平均ADC值分别为（1．22±0．31）×10^-3mm2／s、（1．35±0．23）×10^-3mm2／s，两者比较差异无统计学意义（P〉0．05）；瘤周水肿区平均ADC值分别为（1．26±0．30）×10^-3mm2／s、（1．81±0．12）×10^-3mm2／s，两者比较差异有统计学意义（P〈0．05）；正常脑实质区平均ADC值为（0．89±0．56）×10^-3mm2／s，与前两者分别比较差异有统计学意义（P〈0．05）。结论常规影像学常难以鉴别高级别胶质瘤与单发脑转移瘤，DWI及。H．MRS磁共振波谱分析在二者的鉴别诊断中有重要价值。Objective To investigate the differential diagnostic value of DWI and muhi-voxel 1H magnetic resonance spectroscopy for high-grade gliomas and solitary metastases of tumor. Methods Eighteen cases of high-grade gliomas and 12 cases of solitary metastases of tumor who confirmed by his- topathologic findings or clinical follow-up were selected. All of the patients were performed with conven- tional MR scan, DWI and mutlti-voxel with 2-D mutlti-voxel PRESS 144 ms by GE Signa EXCITE HD 3.0 T super conduct MR unit. Functool software was used for post-processing of spectrum. The ratios of NAA/Cr, NAA/Cho, Cho/Cr were measured in the solid part of masses, circum of tumors and contralat- eral parenchyma respectively. The results were analyzed statistically by SPSS 13.0. Results In the solid part of masses, there was significant difference between high grade gliomas and metastases in the ratios ofCho/NAA （P 〈 0.05）, but there was no significant difference in the ratios of Cho/Cr, NAA/Cr; In peritumoral edema, there weresignificant differences in the ratios of Cho/Cr, Cho/NAA （P 〈 0.05）, but there was no significant difference in the ratios of NAA/Cr （P 〉 0. 05）. The mean ADC values of the necrotic area of high-grade gliomas and metastatic brain tumor capsule were （ 1.22 ±0. 31 ）×10^-3mm2/s and （ 1.35±0. 23） ×10^-3mm2/s, respectively, there was no significant difference （P 〉 0.05）; The mean ADC values of peritumoral edema were （ 1.26± 0. 30） ×10^-3mm2/s and （ 1.81 ± 0. 12） ×10^-3mm2/s, there was significant difference （P 〈 0.05 ） ; The mean ADC value of normal brain parenchyma was （ 0. 89 ± 0. 56）×10^-3mm2/s, which was statistically significant with the former two values （P 〈 0.05）. Con- clusions Conventional imaging is often difficult to identify high-grade gliomas and solitary brain metasta- ses, DWI and 1H-MRS magnetic resonance spectroscopy analysis has important value in the differential diagnosis of them.

关 键 词：磁共振扩散加权成像 磁共振波谱分析 多体素 鉴别诊断 

分 类 号：R44[医药卫生—诊断学] R73[医药卫生—临床医学]