3．0T磁共振氢质子波谱对脑胶质瘤放射性损伤与复发鉴别诊断分析  

Differential diagnosis of radiation injury and glioma recurrence by proton MR spectroscopy at 3.01＂

作　　者：张鑫[1] 张冰[1] 闫婧[2] 杨咏波[3] 陈飞[1] 朱斌[1] 周正扬[1] 李茗[1] 俞海平[1] 李晨[1] 陈伟波 尹震字 刘宝瑞[2] 梁维邦[3] 

机构地区：[1]南京大学医学院附属鼓楼医院 医学影像科 [2]南京大学医学院附属鼓楼医院 肿瘤科 [3]南京大学医学院附属鼓楼医院 神经外科 [4]飞利浦医疗保健事业部 [5]干保中心,江苏南京210008

出　　处：《实用放射学杂志》2012年第12期1852-1856,共5页Journal of Practical Radiology

摘　　要：目的探讨3．0T磁共振氰质子磁共振波谱在脑胶质瘤放射性损伤与复发鉴别诊断中的价值。方法…顺性分析24例脑胶质瘤患者术后、放疗后复查的氯质子磁共振波谱资料，其中15例为放射性损伤，9例为脑胶质瘤复发。利用Philips后处理1：作站（EWS）进行波谱分析，分别得到强化区、周嗣水肿区、对侧正常白质区的Cho／Cr、NAA／。Cr、Cho／NAA比值。结果胶质瘤复发者强化区与水肿区C1lo／Cr、Cho／NAA比值高丁放射性损伤者（P％0．05）。胶质瘤复发者强化区与水肿区Cho／（：r比值分别为3．50±1．10和1．95±0．66；其Cho／NAA比值分别为4．42±1．98和2．14±1．11。放射性损伤者强化区与水肿区Cho／Cr比值分别为1．80±0．21和1．20±0．26；其Cho／NAA比值分别为1．69--＋-0．37和0．84±0．24。强化区Cho／Cr比值的诊断敏感性及特异性分别为93．3％和100％，而水肿区为66．7％和88．9％；Cho／NAA比值的敏感性及特异性分别为86．7％和】100％，而水肿区为73．3％和77．8％。NAA／Cr比值无统计学意义（P〉0．05）。结论3．0T磁共振氢质子磁共振波谱分析在脑胶质瘤放射性损伤与复发鉴别诊断中有重要价值，可以明硅提高鉴别诊断的正确牢。Objective To explore the value of the proton MR spectroscopy at 3.0T in the differential diagnosis of radiation injury and glioma recurrence. Methods Fifteen cases of radiation injury and 9 cases of glioma recurrence were retrospectively studied. The Cho/Cr, NAA/Cr, and Cho/NAA ratios in the enhancing part, peri-loeal edema, and contralateral normal white matter were meas- ured by using a commercially available post processing workstation. Results The Cho/Cr and Cho/NAA ratios in the enhancing part and peri local edema of glioma recurrence were higher than those of radiation injury. The Cho/Cr ratios in the enhancing part of glio- ma recurrence and radiation injury were 3.50±1. 10 and 1.80±0.21 （P=0.002）, and in the peri-local edema, they were 1. 95±0.66 and 1.20±0.26 （P=-0.008）, respectively. The Cho/NAA ratios, in corresponding location, were 4.42±1.98 and 1. 69_＋ 0.37 （P=0.003）, 2.14±1.11 and 0.84±0.24 （P=0.008）, respectively. The susceptihilityand specificity of the（Tho/（＇r ratios in the enhancing part were 93.3% and 100%, and in the peri-loeal edema, they were 66. 7% and 88.9%. The Cho/NAA ratios, in corresponding location, were 86.7% and 100%, 73.3% and 77.8%. There were no statistically differences in the NAA/Cr ratios （P〉0.05）. Conclusion Proton MR spectroscopy can provide very important value in the differential diagnosis of glioma recurrence and radiation injury.

关 键 词：磁共振波谱 放射性坏死 胶质瘤 复发 胆碱 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]