3.0T多体素^(1)H-MRS在脑胶质瘤与单发脑转移瘤鉴别诊断中的应用分析  

Application Analysis for 3.0 T Multi-Voxel ^(1)H-MRS in Differential Diagnosis between Glioma and Single Brain Metastases

作　　者：李红[1] 陈满 黄勇[1] 彭韧 李志铭[1] 谭理连[1] LI Hong;CHEN Man;HUANG Yong(Department of Radiology,The Second Affiliated Hospital of Guangzhou Medical University,Guangzhou,Guangdong Province 510260,P.R.China)

机构地区：[1]广州医科大学附属第二医院放射科

出　　处：《临床放射学杂志》2022年第2期230-235,共6页Journal of Clinical Radiology

基　　金：广州市临床高新、重大、特色技术项目(编号:2019-30)。

摘　　要：目的探索3.0 T多体素氢质子磁共振波谱成像(^(1)H-MRS)在脑胶质瘤、单发脑转移瘤鉴别诊断中的应用价值。方法脑胶质瘤20例、单发脑转移瘤11例纳入研究,均术前行^(1)H-MRS检查。分析脑胶质瘤与单发脑转移瘤瘤体区、瘤周水肿区的胆碱(Cho)/N-乙酰天门冬氨酸(NAA)、Cho/肌酸(Cr)、NAA/Cr值的统计学差异,并用受试者工作特征(ROC)曲线分析各指标鉴别脑胶质瘤与单发脑转移瘤的效能。结果脑胶质瘤组与单发脑转移瘤组间瘤体区Cho/Cr、NAA/Cr及瘤周水肿区Cho/NAA、NAA/Cr值差异均有统计学意义(P<0.05);瘤体区NAA/Cr的ROC曲线下面积(AUC)最大(AUC=0.74),当瘤体区NAA/Cr为1.17时,鉴别脑胶质瘤与单发脑转移瘤的敏感度为55.30%,特异度为82.40%。结论常规MRI结合;H-MRS能提高脑胶质瘤与单发脑转移瘤鉴别诊断的准确性,且瘤体区NAA/Cr值鉴别效能最优。Objective To explore the application value of 3. 0 T multi-voxel ^(1)H-MRS in differential diagnosis for singlebrain metastases and glioma.Methods 20 cases with glioma and 11 cases with single brain metastases were included. All cases underwent multi-voxel ^(1)H-MRS before surgery. Statistical differences of Cho/NAA,Cho/Cr and NAA/Cr between glio-ma and single brain metastases in tumor and peritumoral edema area were analyzed. And these ratios’ efficiencies for differ-ential diagnosis of glioma and brain metastases were analyzed by ROC curve.Results Significant differences were foundin the ratios of Cho/Cr,NAA/Cr in tumor area and Cho/NAA,NAA/Cr in peritumoral edema area between glioma and sin-gle brain metastases(P< 0. 05). The area under the curve(AUC = 0. 74) of NAA/Cr was the largest. The value of NAA/Cr ratio for differential diagnosis between glioma and single brain metastases was 1. 17,the sensitivity was 55. 30%,the spe-cificity was 82. 40%.Conclusion Routine MRI combined with;H-MRS can improve the accuracy of differential diagnosisbetween glioma and single brain metastases,and the best efficiency for differential diagnosis was NAA/Cr value in tumor ar-ea.

关 键 词：脑胶质瘤 脑转移瘤 氢质子磁共振波谱成像 代谢物 受试者工作特征曲线 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]