【作者】 陈加优；

【导师】 段青； 薛蕴菁；

【作者基本信息】 福建医科大学 ， 影像医学与核医学， 2008， 硕士

【摘要】 目的探讨3.0T氢质子磁共振波谱(1H-MRS)在脑星形细胞瘤分级中的临床应用价值。方法采用3.0T超导型磁共振成像波谱一体化扫描系统(MAGNETOM Trio Tim德国西门子公司),分析20例正常脑组织及45例脑星形细胞瘤。其中I级星形细胞瘤6例;II级星形细胞瘤16例;III级星形细胞瘤12例;IV级星形细胞瘤11例;所有患者术前均行MR常规扫描,随后行二维多体素1H-MRS检查,检测肿瘤病灶区及对侧正常参照区N-乙酰门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)、乳酸(Lac)、肌醇(mI)和脂质(Lip)峰代谢物浓度,比较四级肿瘤病灶区代谢物含量及各级内比较肿瘤病灶区与对侧正常参照区NAA/Cr、Cho/Cr及NAA/Cho比值。结果脑星形细胞瘤波谱表现NAA下降,Cho升高,相应NAA/Cho和NAA/Cr比值降低,而Cho/Cr比值升高,23例出现Lac峰,30例出现mI峰,18例出现Lip峰。各组肿瘤病灶区、与对侧正常参照区NAA/Cr、Cho/Cr及NAA/Cho比值比较均有显著性差异( P<0.05 )。病灶区Cho/Cr比值在I、II、III、IV级分别是1.44±0.15、1.85±0.35、2.81±0.22、4.38±0.39;各级别Cho/Cr比值之间均有显著性差异( P<0.05 )。NAA/Cr ,NAA/Cho比值在II、III、IV级间均无显著性差异(P>0.05),I级与II、III、IV级间有显著性差异( P<0.05 )。结论各级别星形细胞瘤1H-MRS N-乙酰门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)、乳酸(Lac)、肌醇( mI)和脂质(Lip)等各种化学成份含量和NAA/Cr、Cho/Cr及NAA/Cho比值均存在着差异,通过测量和分析上述指标可以进一步提高星形细胞瘤分级诊断的准确率,有助于术前手术方案的制定及术后治疗方案的选择。更多还原

【Abstract】 Objective: To investigate the value of 3T 1H-MRS on grading cerebral gliomas.Methods: 3.0 T magnetic resonance spectroscopy (MRS) was obtained in a total of 20 normal cases and 45 patients with cerebral gliomas ( grade one 6, grade two16, grade three 12, grade four 11). 45 cases of astrocytomas underwent routine MRI, and 1H-MRS spectroscopy examination. N-acetylaspartate(NAA),Choline(Cho),Creatine(Cr),Lactate(Lac) and myo-Inositol(mI) were measured in the regions of tumor,and corresponding normal brain. NAA/Cr、Cho/Cr and NAA/Cho ratios were obtained from both the regions of tumor and corresponding normal brain of each group and that of four grades.Results: We can observe the decreasing of NAA and increasing of Cho in the region of tumor. While Lac signal was detected in 23 patients and mI signal was detected in 30 patients, Lip signal was detected in 18 patients. In the regions of tumor, the NAA/Cr,NAA/Cho and Cho/Cr ratios changed significantly by comparing with that of normal control of brain tissue . Cho to Cr ratios of four grades were (1.44±0.15,1.85±0.35,2.81±0.22,4.38±0.39).A significant difference existed the Cho/Cr ratios in the region of tumor among the four group (P<0.05),but no significant different existed the NAA/Cr,NAA/Cho among II to IV groups (P >0.05).Conclusion: Each rank of astrocytoma has difference in various chemical composition content including NAA, Cho, Cr, Lac, Lip, mI etc. NAA/Cr、Cho/Cr and NAA/Cho ratios also exited difference among each rank of astrocytoma. Surveys and analyzes each chemical composition content and the ratio difference of various ranks can improve diagnostic accuracy of astrocytoma, and provides a helpful surgery plan and the choice of treating plan after surgery.更多还原