胶质瘤瘤体及瘤周1H—MRS、ADC值与Ki-67的相关性研究  

The correlation of 1H-MRS, ADC value and proliferative activity Ki-67 of glioma in peritumoral edema region and parenehyma region

作　　者：黄莉[1,2] 黄穗乔[1] 袁小平[1] 钟镜联[1] 叶瑞心[1] 蒋伟[1] 沈启明[1] 

机构地区：[1]中山大学孙逸仙纪念医院放射科,广东广州510120 [2]广州市妇女儿童医疗中心

出　　处：《实用放射学杂志》2013年第6期875-879,共5页Journal of Practical Radiology

摘　　要：目的探讨胶质瘤瘤体区与瘤水肿区1H—MRS相关代谢物比值、ADC值与肿瘤细胞增殖活性Ki-67标志物的相关性，进一步提高对该疾病的认识水平。方法前瞻性收集经手术病理证实的胶质瘤12例完整资料，所有病例术前均行’H—MRs扫描、DWI扫描及MR常规扫描，术后行瘤体及瘤周兴趣区标本肿瘤细胞增殖活性检测。结果（1）12例胶质瘤瘤体强化区具增殖活性的肿瘤细胞密度为（7．56±2．95）％，而瘤周水肿区（1．52±0．76）％。（2）瘤体Cho／Cr比值与肿瘤细胞增殖活性呈正相关（r=0．903，P=0．000）；瘤体与瘤周Cho／NAA比值与肿瘤细胞增殖活性均呈正相关（r=0．662，P=0．019；r=0．653．P=0．021）；瘤周水肿区Cho／Cr比值与肿瘤细胞增殖活性不相关（P=0．412）；瘤体及瘤周NAA／Cr比值与肿瘤细胞增殖活性均不相关（P=0．959、P=0．675）。（3）胶质瘤瘤体ADC值与肿瘤细胞增殖活性呈负相关（r=0．804，P=0．002）；胶质瘤瘤周ADC值与肿瘤细胞增殖活性不相关（P=0．333）。结论瘤体区Cho／Cr比值、Cho／NAA比值与肿瘤细胞增殖活性呈正相关，瘤体区ADC值与肿瘤细胞增殖活性呈负相关，应用这些指标可以准确地评价胶质瘤恶性增殖的生物学行为。Objective To investigate the correlation of 1H-MRS, ADC value and tumor marker Ki-67 of glioma in peritumoraI edema region and parenchyma region, which could improve the understanding of the disease. Methods In this prospective study, full data of 12 cases with glioma proved by biopsy was collected.. Routine MRI, 1 H-MRS and DWI were performed for all patients be- fore operation. Postoperative ROI tumor cell proliferative activity was detected in peritumoral edema region and parenchyma region. Results ①For 12 cases of glioma patients, the density of proliferative tumor cell in tumor enhancement area was （7.56±2.95）%, and peritumoral edema area was （1.52±0.76）%. ②The Cho/Cr ratio was positively correlated with the proliferative activity of tumor cells in parenchyma region（r=0. 903, P=0. 000） ; the Cho / NAA ratio was positively correlated with the proliferative activi- ty of tumor cells in parenchyma region and peritumoral area （r= 0. 662, P= 0. 019; r=0. 653, P=0. 021） ;the Cho / Cr ratio was not correlated with the proliferative activity of tumor cells in peritumoral edema region （P=0. 412）; the NAA / Cr ratio was not correlated with the proliferative activity of tumor cells in parenehyma region or peritumoral edema region （P= 0. 959 ,P= 0. 247）. @The ADC value was negatively correlated with the proliferative activity of tumor cells in parencbyma region （r ^- 0. 804, P= 0. 002） ; the ADC value was not correlated with tumor ceils proliferative activity in peritumoral edema （P= 0. 333）. Conclusion The Cho / Cr ratio and Cho / NAA ratio are positively correlated with the proliferative activity of tumor cells in parenehyma region; the ADC value is negatively correlated with the proliferative activity of tumor cells in parenehyma region; these indicators could ex- actly evaluate the biological behaviors of malignant proliferation for glioma.

关 键 词：胶质瘤 磁共振波谱 表观扩散系数 增殖活性 

分 类 号：R739.41[医药卫生—肿瘤] R445.2[医药卫生—临床医学]