常规磁共振成像结合磁共振波谱在临床脑胶质瘤诊断及鉴别诊断中的应用价值  

The Research of Magnetic Resonance Spectroscopy Imaging Combined MRI in the Clinical Application of Cerebral Gliomas

作　　者：郑建[1] 尚乃舰[1] 王大龙[1] 孙云凤[1] 耿佳时[1] 张颖俏[1] 

机构地区：[1]哈尔滨医科大学附属第三医院放射科,黑龙江哈尔滨150081

出　　处：《现代生物医学进展》2013年第6期1111-1114,共4页Progress in Modern Biomedicine

基　　金：黑龙江省教育厅项目(10543027)

摘　　要：目的:分析磁共振氢质子磁共振波谱(Proton Magnetic Resonance Spectroscopy,1H-MRS)的特征与脑胶质瘤病理分级的相关性,探讨氢质子磁共振波谱及常规磁共振成像(Magnetic Resonance Imaging,MRI)联合应用在提高脑胶质瘤的临床诊断中的应用价值。方法:脑胶质瘤(经临床手术证实及病理诊断确诊)患者34例,参照国际卫生组织诊断标准,分为低级别胶质瘤组及高级别胶质瘤组。其中,低级别组16例,高级别组18例,在行常规MRI检查的同时,配合1H-MRS检查,测NAA(N-乙酰天门冬氨酸)、Cho(胆碱)、C(r肌酸)值,在不同级别胶质瘤、同级别胶质瘤不同位置的代谢物进行综合分析。结果:在获得常规MRI图像并进行诊断后,进行氢质子磁共振波谱检测分析:在低级别胶质瘤及高级别胶质瘤患者中,C(r肌酸)的总量变化不大,有轻度的下降;而NAA(N-乙酰天门冬氨酸)下降程度较为明显;Cho(胆碱)则明显升高。低级别胶质瘤及高级别胶质瘤患侧的肿瘤组织同对侧的正常脑组织的各种代谢物及其比值(Cho、NAA、NAA/Cho、NAA/Cr值)具有显著性差异(P<0.05);低级别胶质瘤及高级别胶质瘤的肿瘤组织的代谢物比值NAA/Cr、NAA/Cho值差异具有显著性(P<0.05)。低级别胶质瘤及高级别胶质瘤的Cho/Cr、NAA/Cho、NAA/Cr值与脑胶质瘤的病理分级具有相关性;在各个比值中,NAA/Cr与NAA/Cho值能够较好地反映脑胶质瘤的病理分级,二者的值呈现负相关;Cho/Cr值呈正相关。结论:常规MRI联合1H-MRS在脑胶质瘤的诊断中,能够有效提高准确性,在临床评估脑胶质瘤的分级、确定范围和鉴别诊断都具有重要的指导作用。Objective： To analyze the value of MRI images combined with proton magnetic resonance spectroscopy （^1H-MRS） in diagnosis, classification and differential diagnosis of gliomas. Methods： Thirty-four cases of MRI according with glioma patients who were carried out ^1H-MRS examination（NAA, Cho, Cr, Lac, Lip and mI wave） were analyzed comprehensively. Results： ^1H -MRS showed that, compared with normal brain essence, NAA decreased, Cho increased, and Cr changed little in total, and they had no regularity. The abnormal Lac and （or） Lip peak appeared in part lesions area, mI descended mildly, and Cho increased in minor surrounding area of lesions area. Conclusion： There is a great value of MRI image combined with ^1H-MRS analysis in classification, diagnosis, scope confirmation and differential diagnosis of cerebral gliomas. This technology can effectively improve the diagnosis accuracy of cerebral gliomas.

关 键 词：脑胶质瘤 MRI 1H-MRS 

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