多体素1H-MRS在脑胶质瘤与脑脓肿鉴别诊断中的应用

摘要

Objective To evaluate the diagnostic value of *H magnetic resonance spectroscopy ^H-MRS) in differentiating glio-mas from brain abscess. Methods sixteen patients with intracranial masses including 10 cases with gliomas (grade II in 3 and grade IE - IV in 7) and 6 cases with abscesses confirmed pathologically underwent MR imaging and proton MR spectroscopy. MR spectro-scopic parmeters were evaluated at the lesions and apposite sides. Results Cho/NAA of glioma(n=10) was higher than that of collateral normal tissues,Cho/NAA of abscesses (n=6) was higer than that of opposite normal tissues. Cho/NAA was no of significant difference between gliomas and brain abscesses; significant differences were found in the ratios of Cho-norm between gliomas and brain abscesses (P<0. 05). Conclusion MR spectroscopy can improve the diagnostic accuracy in differentiating gliomas from brain abscesses.%目的 评价多体素MRS在脑胶质瘤与脑脓肿诊断和鉴别诊断中的应用价值.方法 收集16例脑内占位病例,10例胶质瘤(Ⅲ~Ⅳ级7例,Ⅱ级3例,按照WHO分级标准,均经手术病理证实)、6例脑炎脑脓肿(均经手术病理或穿刺活检证实),所有患者均行MRI常规检查和多体素MRS检查.测量病灶区及对侧正常区的Cho、Cho/NAA,并计算Cho-norm(标准化Cho:病灶区Cho/正常对侧区Cho).结果 10例胶质瘤瘤体Cho/NAA高于对侧正常区,差异有统计学意义;6例脑炎脑脓肿病灶Cho/NAA高于对侧正常区,差异有统计学意义;胶质瘤瘤体Cho/NAA高于脑炎脑脓肿病灶区,然而P＞0.05,差异无统计学意义;胶质瘤瘤体Cho-norm高于脑炎脑脓肿病灶区,差异有统计学意义.结论 多体素MRS中Cho-norm能够帮助鉴别脑胶质瘤及脑炎脑脓肿,从而制订最佳治疗方案.