常规MRI与~1H-MRS结合鉴别高级别脑胶质瘤与单发性脑转移瘤  

Clinical observation of conventional MRI and 1H-MRS in the identification of high-grade gliomas and soli- tary brain metastasis

作　　者：龚光文 田军 吴云兆 熊欣 于星 

机构地区：[1]湘西自治州人民医院磁共振室,湖南吉首416000

出　　处：《临床肿瘤学杂志》2016年第2期170-174,共5页Chinese Clinical Oncology

摘　　要：目的探讨常规磁共振成像(MRI)与氢质子磁共振波谱(1H-MRS)相结合在高级别脑胶质瘤与单发性脑转移瘤中诊断及鉴别诊断的价值。方法选取我院收治经手术病理组织学证实的高级别脑胶质瘤患者27例与单发性脑转移瘤患者21例,进行常规MRI及1H-MRS检查。分析比较常规MRI的影像表现特征及1H-MRS代谢产物[N-乙酰天门冬氨酸(NAA)、胆碱(Cho)和肌酸(Cr)]变化情况。结果常规MRI显示仅病变部位和水肿程度在两者间存在差异(P<0.05)。1HMRS高级别脑胶质瘤与单发性脑转移瘤瘤体区Cho/NAA值比较差异有统计学意义(P<0.05),而NAA/Cr、Cho/Cr值比较差异无统计学意义(P>0.05);两者瘤周区Cho/Cr、Cho/NAA值比较差异均有统计学意义(P<0.05),而NAA/Cr值比较差异无统计学意义(P>0.05)。结论常规MRI与1H-MRS相结合使高级别脑胶质瘤与单发性脑转移瘤诊断及鉴别诊断的准确性得到进一步提高,具有较高的临床应用价值。Objective To investigate the value of conventional MRI and proton magnetic resonancespectroscopy（1H-MRS）in the diagnosis and differential diagnosis of high-grade gliomas and solitary brain metastasis. Methods Twenty-seven patients with high- grade gliomas and 21 patients with solitary brain metastasis were confirmed by surgery and pathology in our hospital. Conventional MRI and 1H-MRS examination were performed. The imaging features and the changes of I H-MRS metabolites, including N-acetylaspartate （NAA） , choline （Cho） and creatine （Cr） were analyzed. Results There were differences between high-grade gliomas and solitary me- tastasis in location and edema extent of the lesions in conventional MRI. As for 1H-MRS, it has statistical significance between high- grade gliomas and solitary brain metastasis body region in Cho/NAA value（ P〈0. 05） , but no statistical significance was observed be- tween NAA/Cr and Cho/Cr values （P〉0.05）. There were statistically significance in peri-tumor region in Cho/Cr and Cho/NAA values （P〈0. 05 ）, while NAA/Cr value has no statistically significance （P〉0. 05 ）. Conclusion The accuracy of conventional MRI and ~H- MRS in diagnosis and differential diagnosis of high-grade gliomas and solitary brain metastases is further improved, and it has high clin- ical application value.

关 键 词：高级别脑胶质瘤 单发性脑转移瘤 磁共振成像 磁共振波谱 

分 类 号：R739.41[医药卫生—肿瘤]