3.0T多体素氢质子磁共振波谱在评价脑胶质瘤病理分级及浸润范围中的应用  

Application of 3.0T multivoxel 1H magnetic resonance spectroscopy to evaluating pathological grading and invasion extent of brain glioma

作　　者：胡丽娟 廖凯兵 

机构地区：[1]湖北省中西医结合医院放射科,武汉市430015

出　　处：《广西医学》2016年第9期1252-1255,共4页Guangxi Medical Journal

摘　　要：目的探讨3.0T多体素氢质子磁共振波谱(1H-MRS)在评价胶质瘤术前病理分级及肿瘤浸润范围中的应用价值。方法脑胶质瘤患者60例,其中低级胶质瘤28例,高级胶质瘤32例;所有患者在术前行3.0T1H-MRS检查,检测肿瘤、瘤周区域、正常脑组织胆碱复合物(Cho)/肌酸(Cr)、N-乙酰-L-天门冬氨酸复合物(NAA)/Cr、NAA/Cho的比值。结果与正常脑组织比较,胶质瘤组织总体Cho/Cr比值升高,NAA/Cr、NAA/Cho比值下降(P<0.05);低、高级别胶质瘤组织的Cho/Cr比值也高于对侧正常脑组织,NAA/Cho及NAA/Cr低于对侧正常脑组织(P<0.05)。高级胶质瘤组织Cho/Cr比值高于低级胶质瘤,NAA/Cho比值低于低级胶质瘤(P<0.05);脑胶质瘤瘤组织Cho/Cr与病理级别呈正相关(P<0.05),NAA/Cho与病理级别呈负相关(P<0.05)。与对侧正常脑组织比较,低级胶质瘤肿瘤周围区域的Cho/Cr比值升高,NAA/Cho及NAA/Cr比值降低(P<0.05),高级胶质瘤肿瘤周围区域的Cho/Cr比值升高,NAA/Cho比值降低(P<0.05)。结论 3.0T多体素1H-MRS能反映胶质瘤细胞的生化物质代谢情况,可在一定程度上评价胶质瘤病理级别及肿瘤浸润范围,从而可提高脑胶质瘤术前诊断的准确性。Objective To explore the application value of 3.0T multivoxel 1H magnetic resonance spectroscopy（1H-MRS） for the evaluation of preoperative pathological grading and invasion extent of brain glioma. Methods Sixty patients with brain glioma included 28 with low-grade brain glioma and 32 with high-grade brain glioma. All patients underwent 3.0T 1H-MRS examination before operation. The ratios of choline（ Cho）/creatine （Cr）, N-Aeetyl-L-aspartic acid （NAA）/Cr and NAA/Cho were measured in tumor tissue, peritumoral tissue and normal brain tissue. Results Compared to the normal brain tissue, the ratio of Cho/Cr increased and the ratios of NAA/Cr and NAA/Cho decreased in the gliomas tissue （P 〈 0.05 ） ;the ratio of Cho/Cr increased while the ratios of NAA/Cho and NAA/Cr decreased in the low-grade glioma and high-grade glioma tissue（ P 〈 0.05 ）. The ratio of Cho/Cr was higher and the ratio of NAA/Cho was lower in the high-grade glioma tissue compared to the low-grade glioma tissue （ P 〈 0.05 ）. The pathological grading positively correlated with the ratio of Cho/Cr in the glioma tissue （ P 〈 0.05 ）, and negatively correlated with the ratio of NAA/Cho （ P 〈 0.05 ）. Compared to the contralateral normal brain tissue, the ratio of Cho/Cr increased while the ratios of NAA/Cho and NAA./Cr decreased in the low-grade glioma peritumoral tissue（ P 〈0.05 ） , and the ratio of Cho/Cr increased while the ratio of NAA/Cho decreased in the high-grade glioma peritumoral tissue （ P 〈 0.05 ）. Conclusion 3.0T multivoxel 1H-MRS can reflect the metabolic condition of biochemical substance in glioma cells, and can evaluate the pathological grading and invasion extent of glioma to a certain extent, thus can improve the preoperative diagnostic accuracy of brain glioma.

关 键 词：胶质瘤 磁共振波谱学 病理分级 浸润 胆碱复合物 肌酸 N-乙酰-L-天门冬氨酸复合物 

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