1hmrs对高级别脑胶质瘤与孤立脑转移瘤的鉴别诊断价值

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1、1HMRS对高级别脑胶质瘤与孤立脑转移瘤的鉴别诊断价值作者：陆永明丁庆国陈振湖贾传海周建春陈珏【摘要】目的初步探讨氢质子磁共振波谱(1HMRS)在高级别脑胶质瘤、孤立脑转移瘤鉴别诊断中的应用价值。方法搜集经手术病理证实的高级别脑胶质瘤18例及孤立脑转移瘤12例，术前分别行常规MRI、增强扫描及1HMRS检查，测量两种肿瘤的实质强化区、中央坏死区、瘤周水肿区的代谢物浓度(包括NAA、Cho、Cr)及其比值的变化，并进行分析比较。结果两种肿瘤的T1WI多表现为等、低信号，T2WI呈不均匀高信号，伴有不同程度强化和瘤周水肿。高级别脑胶

2、质瘤与孤立脑转移瘤实质区的1HMRS均表现为NAA/Cho、NAA/Cr下降，Cho/Cr升高，但其差异无统计学意义;中央坏死区的NAA/Cho、NAA/Cr差异有统计学意义，但Cho/Cr差异无统计学意义;瘤周水肿区NAA/Cho、Cho/Cr差异有统计学意义，但NAA/Cr差异无统计学意义。结论1HMRS可无创地分析脑肿瘤的代谢情况，有助于对高级别脑胶质瘤与孤立脑转移瘤的诊断和鉴别诊断。【关键词】胶质瘤;转移瘤;磁共振　波谱;磁共振成像　　[Abstract]ObjectiveToinvestigatethevalueof1

3、HMRSindifferentialdiagnosisonhigh-gradegliomasandsolitary11metastases.Methods18patientswithhigh-gradegliomasand12patientswithsolitarymetastaseswereconfirmedbypathology.AllcaseswereperformedroutineMRI,contrastenhancedMRIand1HMRSpreoperatively.Threeregions,thesolidcomp

4、onent,necrosisandperitumoraledemaofthetwotypesoftumor,weremeasured,thenthevalueofNAA,Cho,Crandtheirratiowereobtained.Theindependent-samplesttestwasusedtodetermineifthereweresignificantstatisticaldifferenesinmetaboliclevelsofthethreeregionsbetweenthehigh-gradegliomasa

5、ndthemetastase.ResultsThetwotypesoftumorshowedisointenseorhypointenseonT1-weightedimage,heterogeneoushyperintenseonT2-weightedimage,withmultipleenhancementandperitumoraledema.Thesolidcomponentsofhigh-gradegliomasandsolitarymetastasesbothshowedtheratioofNAA/ChoandNAA/

6、Crdecreased,Cho/Crincreased.Buttherewerenosignificantstatisticaldifferencesamongtheratios.NAA/ChoandNAA/Crincentralnecrosisregionshavesignificantstatisticaldifference,whereasCho/Crno.NAA/ChoandCho/Crinperitumoraledemaregionshavesignificantstatisticaldifference,wherea

7、sNAA/Crno.Conclusion1HMRScanbeusedtoanalysizethemetabolismofcerebraltumorbynon-invasiveway，itmaybehelpfultodifferentiatehigh-gradegliomasfromsolitary11metastase.　　[Keywords]metastasis;magneticresonancespectrum;magneticresonanceimaging　　子磁共振波谱(magneticresonancespectro

8、scopy,1HMRS)是目前唯一无创性的观察活体组织代谢与生化指标的磁共振技术，近年来发展迅速，临床上已逐渐应用于脑肿瘤的诊断、鉴别诊断、肿瘤分级等方面的研究[1-2]，对于胶质瘤与转移瘤的比较分析亦见报道，但关于此两种肿瘤坏死区的MRS比较尚未有报道。本文回