3.0T氢质子磁共振波谱成像在胶质瘤术前分级及术后随访中的应用  

The advantages and disadvantages of 3. 0 T spectroscopic imaging in the preoperative grading and postoperative followup of glioma

作　　者：张玉琴[1] 徐海东[1] 董海波[1] 周进龙 

机构地区：[1]浙江省宁波市医疗中心李惠利医院影像科,浙江宁波315041

出　　处：《医学影像学杂志》2016年第2期194-197,共4页Journal of Medical Imaging

基　　金：浙江省宁波市科技局社会发展科研项目(编号:2012C50007)

摘　　要：目的分析3.0T MRS成像在脑胶质瘤术前分级及术后随访中的应用价值。方法对61例临床及常规磁共振成像考虑胶质瘤者行2D-MRS检查并与3D-ASL比较,观察各代谢物成分及比值,术前对胶质瘤级别进行前瞻性判断,对照术后结果进行回顾性分析及随访。结果肿瘤实质部分NAA下降、Cho升高,高级别胶质瘤Cho/NAA为5.3±2.2、Cho/Cr为3.5±1.5,低级别Cho/NAA为1.6±0.3、Cho/Cr为1.8±0.5,差异有统计学意义(P﹤0.05)。术后6月内随访,12例复发,7例并发放射性脑病中4例复发。结论磁共振波谱成像可在术前准确判断胶质瘤级别、术后敏感监测肿瘤复发。与3D-ASL比较,MRS对瘤周水肿肿瘤细胞的浸润及术后放疗后肿瘤复发识别优于3D-ASL。Objective To analyze the advantages and disadvantages of 3. 0 T MRS imaging in brain glioma for the grading before operation and follow up after operation. Methods We performed 2D-MRS examination on 61 cases,which had been considre gliomas by clinic and MRI,to observe the metabolite composition and ratio. We judged the preoperative level of glioma prospectively,compared with the results after operation to conduct retrospective analysis and followed up,and compared with 3DASL. Results We found the parenchyma of tumor decreased NAA,increased Cho. In high grade glioma,Cho / NAA was 5. 3 ±2. 2,Cho / Cr was 3. 5 ± 1. 5,in the lower,Cho / NAA was 1. 6 ± 0. 3,Cho / Cr was 1. 8 ± 0. 5,the difference was statistically significant（ P〈0. 05）. At a mean follow-up of 6 months after operation,we found 12 cases of recurrence,and 7 patients with radiation encephalopathy,among these 4 cases were found in local tumor recurrence. Conclusion Magnetic resonance spectroscopic imaging could accurately judge glioma grade in the preoperatively,monitor tumor recurrence after operation sensitive. Compared with 3D-ASL,MRS was better in the invasion of peritumoral edema of tumor cells and tumor recurrence after operation and postoperative radiotherapy,but it was easily affected by magnetic field stability,scanning positioning effect. Correct choice of scanning range could improve the diagnostic rate.

关 键 词：脑胶质瘤 磁共振成像 波谱成像 三维动脉自旋标记法 

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