HGG与PCNSL患者^(1)H-MRS、ADC的变化及临床意义  

Changes of ^(1)H-MRS and ADC in patients with HGG and PCNSL and their clinical significance

作　　者：罗一博 权建平[1] LUO Yi-bo;QUAN Jian-ping(Department of Medical Imaging,Baoji People's Hospital,Baoji 721000,Shaanxi,CHINA)

机构地区：[1]宝鸡市人民医院医学影像科,陕西宝鸡721000

出　　处：《海南医学》2021年第18期2348-2351,共4页Hainan Medical Journal

摘　　要：目的探讨高级别胶质瘤(HGG)与原发性中枢神经系统淋巴瘤(PCNSL)患者氢质子磁共振波谱(1H-MRS)和表观扩散系数(ADC)的变化及临床意义。方法收集宝鸡市人民医院2018年1月至2020年1月收治的55例HGG及21例PCNSL患者资料,所有患者均进行常规磁共振检查技术(MRI)及1H-MRS、弥散加权成像(DWI)检查,分析HGG、PCNSL患者肿瘤瘤体及镜面正常脑组织1H-MRS代谢物比值和ADC值,制作受试者工作特征曲线(ROC)分析肿瘤瘤体1H-MRS代谢物比值和ADC值对HGG、PCNSL的鉴别价值。结果 HGG患者肿瘤瘤体胆碱(Cho)/肌酸(Cr)、胆碱(Cho)/N-乙酸天门冬氨酸(NAA)分别为2.29±0.21、7.47±1.29,明显高于镜面正常脑组织的 1.02±0.11、0.67±0.09,HGG 患者 NAA/Cr、ADC 分别为 0.59=10.08、(0.80±0.09)×10-3、mm2/s,明显低于镜面正常脑组织的 1.56±0.28、(0.85±0.12)×10-3 mm2/s,差异均有统计学意义(P<0.05);PCNSL 患者肿瘤瘤体Cho/Cr、Cho/NAA分别为 3.29±0.43、5.31 ± 0.59,明显高于镜面正常脑组织的 1.27±0.12、0.79±0.09,NAA/Cr、ADC分别为1.04±0.13、(0.62±0.08)× 10-3 mm2/s,明显低于镜面正常脑组织的1.58±0.23、(0.84±0.12)×10-3 mm2/s,差异均有统计学意义(P<0.05);PCNSL患者肿瘤瘤体NAA/Cr、Cho/Cr明显高于HGG患者,Cho/NAA、ADC明显低于HGG患者,差异均有统计学意义(P<0.05);NAA/Cr、Cho/Cr及Cho/NAA、ADC、4个指标联合对HGG、PCNSL鉴别诊断的曲线下面积分别为0.706、0.766、0.764、0.831、0.939。结论 1H-MRS 的NAA/Cr、Cho/Cr、Cho/NAA及ADC值对HGG及PCNSL 均有鉴别作用,能够指导临床治疗。Objective To investigate the changes of hydrogen proton magnetic resonance spectrum(^(1)H-MRS)and apparent diffusion coefficient(ADC)in patients with high-grade glioma(HGG)and primary central nervous system lymphoma(PCNSL)and their clinical significance.Methods The data of 55 cases of HGG and 21 cases of PCNSL from Baoji People's Hospital during January 2018 and January 2020 were collected.The patients were examined by con-ventional magnetic resonance imaging(MRI),^(1)H-MRS,and diffusion weighted imaging(DWI).The ^(1)H-MRS metabolite ratio and ADC values of tumor body and mirrored normal brain tissues were analyzed in HGG and PCNSL patients.The operating characteristic curve(ROC)of receivers were calculated to analyze the differential value of ^(1)H-MRS metabolite ratio and ADC value of tumor body to HGG and PCNSL.Results The ratios of choline(Cho)/creatine(Cr)and choline(Cho)/N-acetylaspartate(NAA)were 2.29±0.21 and 7.47±1.29,respectively,in the tumor body of HGG patients,which were significantly higher than corresponding 1.02±0.11 and 0.67±0.09 in the mirrored normal brain tissue;and the values of NAA/Cr and ADC were 0.59±0.08 and(0.80±0.09)×10^(-3)mm^(2)/s,respectively,in the tumor body of HGG pa-tients,which were significantly lower than 1.56±0.28 and(0.85±0.12)×10^(-3)mm^(2)/s in the mirrored normal brain tissue;all differences were statistically significant(P<0.05).The ratios of Cho/Cr and Cho/NAA were 3.29±0.43 and 5.31±0.59 in the tumor body of PCNSL patients,which were significantly higher than 1.27±0.12 and 0.79±0.09 in the mirrored nor-mal brain tissue;and the values of NAA/Cr and ADC were 1.04±0.13 and(0.62±0.08)×10^(-3)mm^(2)/s in the tumor body,which were significantly lower than 1.58±0.23 and(0.84±0.12)×10^(-3)mm^(2)/s in the mirrored normal brain tissue;all differ-ences were statistically significant(P<0.05).The ratios of NAA/Cr and Cho/Cr of the tumor body were significantly higher in PCNSL patients than in HGG patients,while the values of Cho/NAA and ADC were significantly lo

关 键 词：高级别胶质瘤 原发性中枢神经系统淋巴瘤 氢质子磁共振波谱 表观扩散系数 鉴别诊断 

分 类 号：R739.4[医药卫生—肿瘤]