摘要
目的探讨3D多体素1H-MRS代谢物改变、并结合形态学改变在脑胶质瘤诊断及分级中的价值。方法选取51例脑胶质瘤患者,所有患者均行开颅手术,病理证实低级16例、Ⅱ级部分区域间变呈Ⅲ级4例,高级31例;所有患者均行颅脑常规核磁共振增强扫描和3D多体素135ms序列扫描。分别测定病变实质、病变周围区域的胆碱(Cho)、肌酸(Cr)、乙酰天门冬氨酸(NAA)、Cho/NAA、Cho/Cr、NAA/Cr比值的变化;对结果进行统计学分析。结果体素内Cho升高提示肿瘤增生活跃、NAA减低提示神经元破坏程度。低级别胶质瘤和高级别胶质瘤瘤体区Cho/Cr、Cho/NAA比值比较差异有统计学意义(P<0.05)。结论多体素1H-MRS结合形态学改变在脑胶质瘤诊断、分级及鉴别诊断中有重要价值;1 H-MRS代谢物改变较敏感,与体素内所包含组织密切相关,在分析代谢物变化时应结合相应区域形态学改变。
Objective To determine whether metabolite ratios in multivoxel3D proton MR spectroscopy(^1H-MRS) is dif-ferent between low-grade and high-grade gliomas and may be useful for diagnosis and glioma grading.Methods MR scan and 3D 1 H-MRS studies of 51 patients with histologically proven(16 low-grade,4Ⅱ-Ⅲ-grade and 31 hight-grade glimas) were retrospec-tively reviewde.Metabolite Cho,Cr,NAA and metabolite ratios Cho/NAA Cho/Cr,NAA/Cr were measured.The metabolite ratios(Cho/NAA,Cho/Cr,NAA/Cr) of low and high-grade gliomas were statistically analyzed.Results The Cho within voxel increased means the tumor proliferation activity.The NAA within voxel reduced means neuronal damaged.The metabolite ratios(Cho/NAA,Cho/Cr,NAA/Cr) of low and high-grade gliomas was significant difference(P〈0.05).Conclusion Metabolite ratios of low-grade gliomas were significantly different from high-grade gliomas.^1H-MRS combined with morphological changes could be useful in gliomas diagnosis and differential diagnosis and grading.^1H-MRS metabolite changes were sensitive,and is closely related to contained tissue within voxel.Analysis of metabolites changes should be combined with the corresponding region of morphological changes.
出处
《四川医学》
CAS
2011年第6期793-796,共4页
Sichuan Medical Journal
基金
四川省卫生厅课题(编号:070025)
关键词
肿瘤
神经上皮
磁共振波谱
neoplasms
neuroepithelial
magnetic resonance spectroscopy