MRI和磁共振质子波谱分析对大脑胶质瘤病的诊断价值  

Diagnostic value of MRI and proton magnetic resonance spectroscopy in gliomatosis cerebri

作　　者：赵红领[1] 高绚照[1] 刘惠萍[1] 马连萍[1] 苗成[1] 

机构地区：[1]河南省新乡市中心医院神经内科三病区,453000

出　　处：《临床神经病学杂志》2013年第6期454-456,共3页Journal of Clinical Neurology

摘　　要：目的探讨MRI和磁共振质子波谱分析(1H-MRS)对大脑胶质瘤病(GC)的诊断价值。方法采用3.0 T磁共振机给9例GC患者作头颅常规MRI+增强扫描,以及7例患者行1H-MRS检查。检测病变区域和对侧相应区域MRS的N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)、肌醇(mI)、乳酸(Lac)、脂质(Lip)峰值,计算NAA、Cho、mI与Cr及Cho与NAA的比值。结果 MRI检查示,病灶均侵犯2个或以上脑叶,位于颞叶9例、额叶6例、胼胝体5例、顶、枕叶和基底节区各4例、岛叶2例、小脑1例。病灶T1WI低或等信号,T2WI高或混杂高信号,占位效应轻。增强扫描,有结节或斑片状强化3例,无强化6例。1H-MRS检查示:与对侧比较,病变区域NAA/Cr降低,Cho/Cr升高,Cho/NAA升高(均P<0.05);NAA峰降低,Cho峰升高(均P<0.05);mI/Cr及mI、Lac、Lip峰值的差异无统计学意义。结论 MRI是诊断GC的首选影像学检查方法,MRS是其非常重要的补充。二者结合对GC的诊断有重要的价值。Objective To explore the diagnostic value of MRI and 1H-magnetic resonance spectroscopy （1H- MRS） in gliomatosis cerebri （GC）. Methods MRI conventional and enhance scan were performed in 9 cases of GC by 3.0 T MR machine,and 1H-MRS was performed in 7 cases. The peaks of N-acetyl aspartate（NAA） ,creatine（Cr） , cholines （ Cho）, myo-inositol （ mI）, lactate （ Lac）, lipid （Lip） in the lesion area and contralateral cnn＇esponding region were measured. The ratio of Cho,mI,NAA and Cr,and radio of Cho and NAA were figured up. Results More than two cerebral lobes were at least involved in each GC patint in MRI conventional scan. These tumors invnlved 9 temporal lobes ,6 frontal lobes ,5 corpus callosums ,4 parietal lohes,4 occipital lobes ,4 basal ganglias ,2 insnlar lobes and 1 cerebellum. The lesions showed iso-intensity or hypo-intensity signal on T1WI, hyperintensity or mixed hyperintensity signal on T2WI. The area invaded by tumor showed slight space occupying effect. There was nodular or patchy enhancement in 3 cases, no contrast enhancement in 6 cases in MRI enhance scan. 1 H-MRS showed that the ratio of NAA/Cr in lesion area was significantly lower than those in contralateral normal area（ allP 〈 0.05） , the ratio of Cho/Cr, and of Cho/NAA were significantly higer than contralateral normal area, （ all P 〈 0. 05 ）. The peak of NAA was descended, the peak of Cho was elevated, （all P 〈 0. 05）. There was no statistical significance in ratio of ml/Cr, peaks of mI and Lae and Lip between the two areas. Conclusions MRI is the first choice to detect GC so far, 1H- MRS is a vei7 important supplement. Combining MRI and 1 H-MRS has significant value in /he diagnose of GC.

关 键 词：胶质瘤病 MRI 磁共振质子波谱分析 

分 类 号：R739.41[医药卫生—肿瘤]