磁共振波谱多体素及单体素在诊断低级别胶质瘤急性和亚急性期脑梗死及病毒性脑炎中的诊断价值分析  

Analysis on Value of Multivoxel and Monovoxel of 1H-MRS in the Diagnosis of Low-grade Glioma Acute and Subacute Cerebral Infarction and Viral Encephalitis

作　　者：白雪冬[1] 仇恒志[1] 王胜林[1] 邢千超 曹振东[1] 曹宏伟[1] 万立野[1] BAI Xuedong;QIU Hengzhi;WANG Shenglin(Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院放射科,河北承德067000

出　　处：《河北医学》2020年第10期1702-1706,共5页Hebei Medicine

基　　金：河北省医学科学重点科技研究计划项目,(编号:20200385);河北省承德市科学技术研究与发展计划项目,(编号:201701A082)。

摘　　要：目的:探讨磁共振波谱(MRS)多体素及单体素在诊断低级别胶质瘤,急性和亚急性期脑梗死及病毒性脑炎中的价值。方法:回顾性分析我院76例患者的临床及影像学资料,其中病毒性脑炎27例,脑梗死28例,低级别胶质瘤21例,均使用Magnetom Verio 3.0T MR行常规MR、单体素及多体素MRS检查,利用spectroscopy软件对波谱数据进行分析,比较三组病例的MRS代谢物比率。结果:Cho/Cr,NAA/Cho,NAA/Cr在低级别胶质瘤,急性和亚急性期病毒性脑炎及脑梗死方差分析显示差异有统计学意义(P<0.05),低级别胶质瘤Cho/Cr,NAA/Cho,NAA/Cr高于脑炎组及脑梗死组(P<0.05),病毒性脑炎与脑梗死间比较Cho/Cr,NAA/Cho,NAA/Cr差异无统计学意义(P>0.05),低级别胶质瘤病例中有2例见Lac峰,18例见MI峰,脑梗死24例病人出现Lac峰,Cho/Cr诊断界值为2.35时,鉴别低级别胶质瘤与病毒性脑炎和脑梗死的灵敏度为90.5%,特异度为91%。结论:MRS多体素及单体素技术结合实行优势互补,在诊断低级别胶质瘤,急性和亚急性期脑梗死及病毒性脑炎鉴别诊断中具有一定的临床价值,Cho/Cr比值对于低级别胶质瘤与急性和亚急性期病毒性脑炎和脑梗死鉴别的价值较大。Objective:To explore the value of H-MRS SVS and CSI in the diagnosis of low-grade gliomas,Acute and subacute cerebral infarction and viral encephalitis.Methods:The clinical and imaging data of 76 patients in our hospital were analyzed retrospectively,including 27 cases of viral encephalitis,28 cases of cerebral infarction,21 cases of low-grade gliomas.All patients were examined with magnetic Verio 3.0T MR for routine MR,SVS and CSI,and the spectral data were analyzed with spectroscopy software to compare the ratio of MRS metabolites in the three groups.Results:Cho/Cr,NAA/CHO,NAA/Cr in low-grade gliomas,viral encephalitis and cerebral infarction analysis of variance showed significant differences,further comparisons:There were significant differences in CHO/Cr,NAA/CHO,NAA/Cr between low-grade gliomas and encephalitis(P<0.05),Cho/Cr,NAA/CHO,NAA/CR of low-grade glioma were higher than those of encephalitis group and cerebral infarction group(P<0.05),There was no significant difference in NAA/CHO and NAA/Cr(P>0.05).Lac peak was found in 2 cases of low-grade gliomas,18 cases of MI peak and 24 cases of cerebral infarction.When Cho/Cr diagnostic threshold was 2.35,the sensitivity and specificity of differentiating low-grade gliomas from viral encephalitis and cerebral infarction were 90.5%and 91%respectively.Conclusion:The combination of multivoxel and single voxel technology of 1 HMRS has certain clinical value in the differential diagnosis of low-grade glioma,acute and subacute cerebral infarction and viral encephalitis.Cho/Cr ratio is of great value in differentiating low-grade glioma from acute and subacute viral encephalitis and cerebral infarction.

关 键 词：磁共振波谱 低级别胶质瘤 病毒性脑炎 脑梗死 急性及亚急性期 

分 类 号：R739.4[医药卫生—肿瘤] R743.33[医药卫生—临床医学] R512.3