中国磁共振波谱诊断胶质瘤术后复发与放射性脑损伤  

MR Spectroscopy for Differentiating Recurrent Glioma and Postoperative Brain Radiation Injury:A Retrospective Study in China

作　　者：王莉[1] 孙立新[1] 于学文[1] 王芳[1] 胡军[1] 田静[1] 

机构地区：[1]山东大学附属省立医院影像科,山东济南250022

出　　处：《中国医学影像学杂志》2014年第7期535-539,共5页Chinese Journal of Medical Imaging

摘　　要：目的探讨中国磁共振波谱鉴别诊断胶质瘤术后复发与放射性脑损伤的价值。资料与方法检索中国知网和万方数据库,按照Cochrane协作网推荐的诊断试验纳入标准筛选文献,对纳入研究进行异质性检验,选择相应的效应模型计算其汇总效应量,绘制受试者工作特征曲线并得出诊断阈值、灵敏度及特异度。结果胶质瘤复发时Cho/NAA波峰比值较放射性脑损伤高(P<0.05);NAA/Cr诊断阈值为1.01时诊断放射性脑损伤的灵敏度和特异度分别为77.8%和55.6%;Cho/Cr诊断阈值为1.67时诊断胶质瘤复发的灵敏度和特异度分别为81.8%和81.8%;Cho/NAA诊断阈值为2.27时诊断胶质瘤复发的灵敏度和特异度分别为85.7%和100.0%;Cho/NAA诊断阈值为2.14时诊断胶质瘤复发的灵敏度和特异度分别为100.0%和85.7%。结论磁共振波普可以作为一种无创性地鉴别诊断胶质瘤复发与放射性脑损伤的可靠方法,特别是Cho/Cr波峰比值及Cho/NAA波峰比值。Purpose To explore the value of MR spectroscopy （MRS） in the differential diagnosis between recurrent glioma and postoperative brain radiation injury in China.Materials and Methods The published articles were searched in CNKI database and Wanfang Data according to the diagnostic test inclusion criteria recommended by the Cochrane Collaboration Net.The heterogeneity test was taken and the pooled weighted effect size was calculated according to the corresponding effect model.The cut off values and corresponding sensitivity,specificity were also calculated.Results The pooled Cho/ NAA value of recurrent glioma was higher than that of brain radiation injury （P＜0.05）.When the cut off value of NAA/Cr was 1.01,the corresponding sensitivity and specificity were 77.8％ and 55.6％,respectively.When the cut off value of Cho/Cr was 1.67,the sensitivity and specificity were 81.8％ and 81.8％,respectively.When the cut offvalue of Cho/NAA was 2.27,the sensitivity and specificity were 85.7％ and 100.0％,respectively.When the cut offvalue of Cho/NAA was 2.14,the sensitivity and specificity were 100.0％ and 85.7％,respectively.Conclusion MRS can be used as a reliable non-invasive method to differentiate recurrent glioma and brain radiation injury,especially in terms of Cho/Cr value and Cho/NAA value.

关 键 词：神经胶质瘤 肿瘤复发 局部 脑疾病 辐射损伤 磁共振波谱学 诊断 鉴别 Meta分析 

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