3.0 T ^1H-MRS在脑内高级别星形细胞瘤及单发转移瘤鉴别诊断中的价值  

Value of 3.0 T1H-MRS in differentiating high-grade astrocytoma from solitary intracranial metastases

作　　者：王国华[1] 范海芸 宋修峰[2] 冯磊[1] 张通[1] 王弘岩[1] 徐志鹏[1] 杨璇[1] 姜海毅[1] 

机构地区：[1]山东省青岛市市立医院影像科,山东青岛266011 [2]青岛大学附属医院,山东青岛266002

出　　处：《中国中西医结合影像学杂志》2014年第5期460-462,F0002,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：青岛市公共领域科技支撑计划项目[2012-1-3-1-(21)-nsh]

摘　　要：目的：探讨多体素氢质子磁共振波谱（1H-MRS）对脑高级别星形细胞瘤、单发脑转移瘤的鉴别诊断价值.方法：收集经手术、活检病理证实的颅脑肿瘤患者37例,其中高级别星形细胞瘤（Ⅲ～Ⅳ级）17例（间变性星形细胞瘤5例,胶质母细胞瘤12例）,脑单发转移瘤20例.37例行颅脑常规MRI检查及多体素1H-MRS分析,分析肿瘤实质强化区、强化边缘区、对侧相应正常区域脑组织的生化代谢物及其比值,并进行对照.结果：①脑高级别星形细胞瘤、脑转移瘤1 H-MRS与对侧相应正常区域对比均表现为Cho峰升高,NAA、Cr峰下降.12例胶质母细胞瘤中,显示Lip峰者11例.20例脑转移瘤中,11例见Lac峰升高,9例Lip峰升高.②高级别星形细胞瘤肿瘤实体区的Cho/NAA明显高于脑转移瘤（P＜0.05）;高级别星形细胞瘤瘤周水肿的Cho/Cr、Cho/NAA明显高于脑转移瘤（P＜0.05）.结论：3.0 T 1H-MRS分析对高级别星形细胞瘤、脑单发转移瘤的诊断和鉴别诊断有重要价值,可作为一种非损伤性的鉴别手段;肿瘤瘤周水肿带的波谱更有利于胶质瘤与转移瘤的鉴别.Objective：To assess the value of multi-voxel proton MR spectroscopy （MRS） in differentiating solitary brain metastases and high-grade gliomas. Methods： 37 patients with histologically verified brain tumors were collected： 17 patients with high-grade gliomas （5 AA and 12 GBM） and 20 patients with metastatic brain tumors. All patients were underwent MRI and MRS. The metabolite ra- tios of Cho/Cr, Cho/NAA, NAA, Cr and MI were assessed from spectral maps in the tumoral core, peritumoral edema, and contralateral normal-appearing white matter. Results：The ratios of Cho/Cr,Cho/NAA increased and NAA and Cr peak decreased in the parenchymal core of brain tumors compared with normal tissue. The ratio of Cho/Cr in the neoplasm entity of the high-grade gliomas was significantly higher than that in the metastases （P〈0.05）, and the ratios of Cho/Cr,Cho/NAA of the surrounding edema area of high-grade glio mas were significantly higher than that in the metastatic sarcoma （P〈0. 05）. Conclusion.. MRS has value in detecting and differentiating high-grade astrocytomas from solitary intraeranial metastases.

关 键 词：星形细胞瘤 胶质母细胞瘤 磁共振成像 

分 类 号：R739.4[医药卫生—肿瘤]