磁共振DWI联合MRS在诊断脑肿瘤中的临床价值  

Value Analysis of Combined Application of Magnetic Resonance DWI and MRS Technology in Differential Diagnosis of Brain Tumors

作　　者：王涛[1] 徐隽[1] 阳波[1] 李世军[2] WANG Tao;XU Jun;YANG Bo;LI Shi-jun(Department of Radiology,the Fourth People's Hospital of Sichuan Province,Chengdu 610016,Sichuan Province,China;Department of Neurosurgery,Sichuan Provincial People's Hospital,Chengdu 610110,Sichuan Province,China)

机构地区：[1]四川省第四人民医院放射科,四川成都610016 [2]四川省人民医院神经外科,四川成都610110

出　　处：《中国CT和MRI杂志》2021年第6期21-25,共5页Chinese Journal of CT and MRI

摘　　要：目的探讨磁共振(MR)弥散加权成像(DWI)联合波谱分析技术(MRS)在诊断脑肿瘤中的临床价值。方法选取我院在2013年8月至2018年7月间收治的126例确诊的脑肿瘤患者为研究对象,患者均行MRI平扫+增强扫描,并进行DWI及MRS分析,收集患者影像学资料及临床资料,分别计算患者患侧以及健侧的ADC值,并对NAA、Cho、Cr等在内的肿瘤代谢物值进行计算。结果颅内脑外肿瘤中脑膜瘤患者平均ADC值明显高于对侧正常脑组织ADC值(P<0.05)。脑内肿瘤中脑转移瘤患者平均ADC值明显高于对侧正常脑组织ADC值(P<0.05);胶质瘤患者平均ADC值明显高于对侧正常脑组织ADC值(P<0.05)。脑转移瘤、脑膜瘤、胶质瘤及星形细胞瘤NAA/Cr、NAA/Cho均明显低于正常脑组织NAA/Cr、NAA/Cho水平,而Cho/Cr高于正常脑组织Cho/Cr水平(P<0.05);与脑转移瘤和脑膜瘤相比,星形细胞瘤NAA/Cho和NAA/Cr明显升高,而脑膜瘤的Cho/Cr高于星形细胞瘤、转移瘤(P<0.05);胶质瘤的NAA/Cr、NAA/Cho水平均低于转移瘤且高于脑膜瘤(P<0.05);对于脑转移患者,其中7例Lac峰以及11例LIP峰;对于脑膜瘤患者,其中3例Lac峰、8例Lac和3例Ala峰;对于星形细胞癌患者,其中9例Lac峰、3例Lip峰;对于胶质瘤患者,其中2例Lip峰、6例Lac峰、1例Ala峰。结论磁共振DWI联合MRS对于脑肿瘤患者的检查,不仅对脑肿瘤具有一定的诊断和鉴别诊断价值,且结合MRI常规检查可对肿瘤的类型进行定性分析,从而指导临床医生进行正确的判断和治疗,值得临床推广应用。Objective To investigate the value of combined application of magnetic resonance DWI and MRS technology in differential diagnosis of brain tumors.Methods Between August 2013 and J uly 2018,126 patients diagnosed with brain tumors by surgery and pathological examination in our hospital were selected.Patients received the image examinations(MRI,DWI,MRS).The imaging and clinical data were collected;The AD values of the affected side and the contralateral side were calculated.NAA,Cho,Cr and other metabolite peaks were measured.Results The average ADC values of meningioma,brain metastases,astrocytoma and glioma patients were significantly higher than those of normal contralateral brain tissue(Ps<0.05);The levels of the NAA/Cr and NAA/Cho among five tissues in a descending order was normal tissue,astrocytoma tissue,metastases tissue,glioma tissue and meningioma tissue(Ps<0.05);While the levels of Cho/Cr among five tissues in an ascending order was normal tissue,astrocytoma tissue,metastases tissue,meningioma tissue(Ps<0.05);In brain metastases patients,Lac peak and Lip peak were found in 7 and 11 cases,respectively.There were 3,8 and 3 cases of Lac peak,Lip peak and Ala peak in meningioma patients;There were 9 and 3 cases of Lac peak and Lip peak in astrocytoma patients;In glioma patients,Lac peak,Lip peak and Ala peak were found in 2,6 and 1 cases,respectively.Conclusion The combined application of magnetic resonance DWI and MRS technology has a certain differential diagnosis value for brain tumors,which can classify and qualitatively analyze the malignant degree of tumors,and guide the judgment and treatment.It is wo rthy of promotion.

关 键 词：磁共振MRS技术 磁共振DWI技术 脑肿瘤 诊断及临床价值 

分 类 号：R445.2[医药卫生—影像医学与核医学]