3.0T氢质子磁共振波谱在颅脑良恶性病变鉴别初步应用.doc

3.0T氢质子磁共振波谱在颅脑良恶性病变鉴别初步应用 　 作者：陈加优, 孙斌, 薛蕴菁, 段青 【摘要】 目的 探讨3.0T氢质子磁共振波谱(1HMRS)鉴别颅脑良恶性病变的价值。 方法 19例恶性病变、11例良性病变、20例健康人行1HMRS检查,测定各代谢物的波峰下面积、峰高及N-乙酰天门冬氨酸(NAA),胆碱复合物(Cho)与肌酸(Cr)的比值。 结果 良性病变NAA峰下降,Cho峰升高,NAA/Cr为(0.48±0.54),Cho/Cr为(1.81±0.33)。恶性病变NAA及Cr均降低,Cho升高,NAA/Cr为(0.64±0.60),Cho/Cr为(2.47±0.56)。良恶性病变Cho/Cr的差别有统计学意义。 结论 3T1HMRS能为颅脑病变的定性诊断提供重要信息。 【关键词】 磁共振波谱学; 脑肿瘤; 磁共振成像 ABSTRACT: Objective To investigate the value of 3T 1H-MRS in diagnosis and differential diagnosis of the craniocerebral diseases. Methods 19 patients with malignancies，11 patients with benign lesions and 20 normal cases underwent 1H-MRS. The area within the spectra and peak height of each metabolin were measured in the regions of lesion and normal brain. The ratios of N-aeetylaspartate (NAA) to Creatine (Cr) and Choline compound (Cho) to Creatine (Cr) were obtained from both the regions of lesion and normal brain. Results The spectra of benign lesions showed the decrease of NAA and increase of Cho. NAA to Cr ratio of benign lesions was (0.48±0.54). Cho to Cr ratio of benign lesions was (1.81±0.33). The spectra of malignancies showed the decrease of NAA and Cr, the normality of Cho increase. NAA to Cr ratio of malignancies was (0.64±0.60). Cho to Cr ratio of malignancies was (2.47±0.56). A significant difference exist the Cho/Cr ratios in the regions of lesion between benign lesions and malignancies ［(2.47±0.56) vs (1.81±0.33), Plt;0.05］. Conclusion 3T 1H-MRS can provide important information in the qualitative diagnosis of craniocerebral diseases. KEY WORDS: magnetic resonance spectroscopy; brain tumor; magnetic resonance imaging 氢质子磁共振波谱(1HMRS)是一种新的脑功能成像技术,能够在活体对代谢产物进行无创性检测。目前临床上关于颅脑病变的1HMRS研究主要采用1.5T磁共振仪。本研究通过3.0T磁共振仪对正常组织及病变的1HMRS检查,旨在获得一组相关的数据及谱线特征,为颅脑病变的定性诊断提供重要信息。 　　1 对象与方法 　　1.1 对象 　　搜集2006年12月―2007年4月行MRS检查且经病理学诊断或经临床及综合影像证实的颅脑病变患者30例,其中恶性病变19例,男性8例,女性11例,年龄中位数45岁(26~75岁);包括星形细胞瘤14例(Ⅱ级4例,Ⅲ级5例,Ⅳ级5例)及转移瘤5例。良性病变11例,男性7例,女性4例,年龄中位数35岁(23~60岁),包括脑膜瘤7例及脑脓肿4例。健康体检者20例,男性11例,女性9例,年龄中位数30岁(18~65岁)