高级别胶质瘤和脑转移瘤的二维多体素氢质子磁共振波谱

摘要

目的 比较高级别胶质瘤及脑转移瘤代谢产物的氢质子波谱变化规律.方法 经病理学证实的18例高级别胶质瘤和12例脑转移瘤患者行磁共振头颅平扫、增强和二维多体素氢质子磁共振波谱检查,采用分析软件包Func-Tool在代谢与解剖叠加图像上选择感兴趣区(ROI),取4个个体素,移动像素至肿瘤实体区、肿瘤周边区及对侧正常区.结果 高级别胶质瘤与脑转移瘤瘤体区与瘤周区Cho/Cr比值升高,二者存在显著性差异,高级别胶质瘤和脑转移瘤NAA/Cr无显著性差异.结论 多体素二维氢质子波谱对于鉴别高级别胶质瘤及脑转移瘤以及了解肿瘤浸润的范围可提供有价值的信息.%Objective To compare the changes of 1H-MRS of metabolism of high-grade gliomas and metastases. Meth-ods MR imaging were performed in 18cases of high-grade, gliomas and 12 cases of metastases proved surgically and pathologi-cally. The sequences included plain scan,contrast-enhanced scan and 2D multi voxel 1H-MRS. The region of interest on metabol-ic-anatomic images were selected into 4 pixels with software FuncTool. Each pixel was separately located at tumor area, the sur-rounding area of tumor and normal control area. According to spectra of these areas, N-acetylaspartate/Choline (NAA/Cho), NAA/creatine(Cr) and Cho/Cr ratios were calculated. Results The ratio Cho/Cr of tumors was elevated in high-grade gliomas: and metastases, the difference was significant (P<0.05), The ratio Cho/Cr of tumors was elevated in the peritumoral region of high-grade gliomas but not in metastases. While the ratio of NAA/Cr in the peritumoral region of high-grade and metastases was not statistical significant (P<0.05) . Conclusion Two-dimensional multivoxel proton magnetic resonance spectroscopy (1H-MRS) may provide valuable information for disfinuishing high-grade gliomas from solitary metastases and understanding the region infiltrated by tumor.