氢质子磁共振波谱在胶质瘤术前分级中的应用价值  

PRACTICAL VALUE OF HYDROGEN PROTON MAGNETIC RESONANCE SPECTROSCOPY IN PREOPERATIVE GRADING OF GLIOMAS

作　　者：刘娜[1] 隋庆兰[1] 赵继平[1] 王家臣[1] 段崇锋[1] 牛蕾[1] 刘学军[1] 任延德[1] LIU Na;SUI Qinglan;ZHAO Jiping;WANG Jiachen;DUAN Chongfeng;NIU Lei;LIU Xuejun;REN Yande(Department of Radiology,The Affiliated Hospitai of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院放射科,山东青岛266003

出　　处：《精准医学杂志》2019年第1期48-51,共4页Journal of Precision Medicine

基　　金：山东省医药卫生科技发展计划项目(2016WS02-85);青岛市民生科技计划项目(14-2-3-7-nsh)

摘　　要：目的探讨氢质子磁共振波谱(1 H-MRS)在胶质瘤术前分级中的应用价值。方法回顾性分析术前行1 H-MRS检查、术后经病理组织学检查证实为胶质瘤的病人52例,其中高级别胶质瘤24例,低级别胶质瘤28例。采用GE 3.0T超导磁共振对肿瘤感兴趣区行多体素扫描计算代谢物比值变化,并通过受试者工作特征曲线(ROC曲线)确定高低级别胶质瘤各代谢物比值的阈值。结果高级别胶质瘤较低级别胶质瘤N-乙酰天门冬氨酸(NAA)/肌酸(Cr)比值明显下降(t=-2.814,P<0.01),胆碱(Cho)/Cr、Cho/NAA比值明显升高(t=2.454、2.671,P<0.05)。Cho/Cr、Cho/NAA、NAA/Cr各ROC曲线下面积(AUC)分别为0.696、0.729和0.708,分别计算出鉴别高低级别胶质瘤Cho/Cr比值的最佳诊断阈值为2.51,诊断灵敏度为57.1%,诊断特异度为83.3%;Cho/NAA比值的最佳诊断阈值为3.68,诊断灵敏度为71.4%,诊断特异度为75.0%;NAA/Cr比值的最佳诊断阈值为0.60,诊断灵敏度及特异度均为75.0%。结论 ~1H-MRS在胶质瘤的术前分级中有一定价值。Objective To investigate the practical value of hydrogen proton magnetic resonance spectroscopy(1H-MRS)in the preoperative grading of gliomas.Methods A retrospective analysis was conducted for 52 patients with gliomas(28 low-grade gliomas and 24 high-grade gliomas)who had undergone a preoperative 1H-MRS examination and had been confirmed as gliomas by a postoperative histopathological examination.Multi-voxel magnetic resonance spectroscopy with a GE 3.0 T superconductive magnet was performed to calculate the changes in metabolite ratios in the region of interest of tumor,and the thresholds of metabolite ratios between high-grade gliomas and low-grade gliomas were determined by a receiver operating characteristic(ROC)curve.Results Compared with low-grade gliomas,high-grade gliomas showed a significantly reduced ratio of N-acetylaspartate(NAA)/creatinine(Cr)(t=-2.814,P<0.01)and significantly increased ratios of choline(Cho)/Cr and Cho/NAA(t=2.454,2.671,P<0.05).The areas under the ROC curves of Cho/Cr,Cho/NAA,and NAA/Cr were 0.696,0.729,and 0.708,respectively.The optimal diagnostic threshold,diagnostic sensitivity,and diagnostic specificity for differentiating high-grade gliomas from low-grade gliomas were 2.51,57.1%,and 83.3%,respectively,when taking Cho/Cr as the standard,were 3.68,71.4%,and 75.0%,respectively,when taking Cho/NAA as the standard,and were 0.60,75.0%,and 75.0%,respectively,when taking NAA/Cr as the standard.Conclusion 1H-MRS shows some value in the preoperative grading of gliomas.

关 键 词：神经胶质瘤 质子磁共振光谱法 肿瘤分级 

分 类 号：R730.264[医药卫生—肿瘤] R445.2[医药卫生—临床医学]