魔角旋转高分辨离体质子波谱在常见脑肿瘤中的研究

目的探讨离体脑膜瘤和胶质瘤魔角旋转高分辨质子波谱(HRMAS1H-MRS)特点及其在病理分级中的价值.资料与方法经手术病理证实的脑肿瘤32例(脑胶质瘤21例,脑膜瘤11例),其中胶质瘤又分为良性组、过渡组和恶性组.将其离体标本在室温下600 MHz波谱仪上行HRMAS1H-MRS采集.检测的化合物包括氮-乙酰天门冬氨酸(NAA),胆碱类化合物(Cho)、谷氨酸和谷氨酰氨(Glu-Gln)、甘氨酸(Gly)、牛磺酸(Tau)、肌醇(mI)、丙氨酸(Ala)、乳酸(Lac)等.将3组胶质瘤代谢物相对浓度及脑膜瘤和胶质瘤的代谢物相对浓度进行比较.结果 (1)Cho/Cr在良性组与过渡组和良性组与恶性组间有显著性差异(P＜0.05和P＜0.001),而过渡组与恶性组间无显著性差异(P＞0.05);Gly/Cr在良性组与恶性组间存在显著性差异(P＜0.05),良性组与过渡组及过渡组与恶性组间无显著性差异(P＞0.05和P＞0.05);Tau/Cr在良性组与恶性组和过渡组与恶性组间有显著性差异(P＜0.05和P＜0.05),而良性组与过渡组之间无显著性差异(P＞0.05);NAA/Cr、Ala/Cr、mI/Cr、Glu-Gln/Cr、Lac/Cr和Lip/Cr组间差异无显著性(P＞0.05).(2)在胶质瘤和脑膜瘤的比较中,脑膜瘤中的Ala/Cr、Cho/Cr、Glu-Gln/Cr、Tau/Cr和Lac/Cr都较胶质瘤高,其差异有统计学意义(P＜0.05),而NAA/Cr比胶质瘤低,差异也有统计学意义(P＜0.05),mI/Cr、Lip/Cr、Gly/Cr组间差异无统计学意义(P＞0.05).结论 HRMAS1H-MRS能提供胶质瘤与脑膜瘤丰富的生化信息,在胶质瘤与脑膜瘤的鉴别诊断及胶质瘤分级评估中有独特的应用价值.     

Absolute choline concentration measured by quantitative proton MR spectroscopy correlates with cell density in meningioma

Introduction  This study was aimed to investigate the relationship between quantitative proton magnetic resonance spectroscopy (1H-MRS) and pathological changes in meningioma. Materials and methods  Twenty-two meningioma cases underwent single voxel 1H-MRS (point-resolved spectroscopy sequence, repetition time/echo time = 2,000 ms/68, 136, 272 ms). Absolute choline (Cho) concentration was calculated using tissue water as the internal reference and corrected according to intra-voxel cystic/necrotic parts. Pathological specimens were stained with MIB-1 antibody to measure cell density and proliferation index. Correlation analysis was performed between absolute Cho concentration and cell density and MIB-1 labeled proliferation index. Results  Average Cho concentration of all meningiomas before correction was 2.95 ± 0.86 mmol/kg wet weight. It was increased to 3.23 ± 1.15 mmol/kg wet weight after correction. Average cell density of all meningiomas was 333 ± 119 cells/HPF, and average proliferation index was 2.93 ± 5.72%. A linear, positive correlation between cell density and Cho concentration was observed (r = 0.650, P = 0.001). After correction of Cho concentration, the correlation became more significant (r = 0.737, P < 0.001). However, no significant correlation between Cho concentration and proliferation index was found. There seemed to be a positive correlation trend after correction of Cho concentration but did not reach significant level. Conclusion  Absolute Cho concentration, especially Cho concentration corrected according to intra-voxel cystic/necrotic parts, reflects cell density of meningioma. Grant: This study was supported by the Japan-China Sasakawa Medical Fellowship (Nippon Foundation, Japan)     

1H-MRS在细菌性脑脓肿中的应用研究

目的 回顾性分析细菌性脑脓肿氢质子磁共振波谱（^1H-MRS）特征，评价^1H-MRS在细菌性脑脓肿诊断和疗效监测中的应用价值。资料与方法 经病理组织学证实的细菌性脑脓肿20例，17例^1H-MRS有能分辨的信噪比（SNR），点分辨波谱（PRESS）序列采集病灶中心，比较分析代谢物出现概率。结果 （1）17例细菌性脑脓肿：耳源性2例，肺源性3例，心源性2例，隐源性5例，其他5例。（2）15例细菌性脑脓肿有氨基酸（AA）峰，敏感性88．23％，特异性100％。另2例仅有乳酸（Lac）或脂质（Lip）峰。9例乙酸盐（Ace）峰，敏感性52．3％；7例琥珀酸盐（Sue）峰，敏感性41．2％；6例丙氨酸（Ah）峰，敏感性35．3％；Lip峰和胆碱（Cho）、氮-乙酰天门冬氨酸（NAA）、肌酸（Cr）／磷酸肌酸（PCr）峰各3例。（3）8例平均治疗38d后^1H-MRS复查，从峰和Ace峰降低或消失，仅剩Lae峰。（4）细菌性脑脓肿有两种波谱模式：一种是除了从峰、Lac峰，还有Ace峰、Sue峰或Ah峰（12例）；另一种是仅有从、Lac峰，而没有Ace峰、Sue峰或Ala峰（3例）。结论 从峰是细菌性脑脓肿特征性的峰；^1H-MRS能反映细菌性脑脓肿的疗效；脓肿不同波谱模式可能提示不同的细菌感染。     

多体素1H - MRS在脑肿瘤强化周围区域中的临床应用

目的探讨多体素1H磁共振波谱(1H-MRS)在颅脑肿瘤强化周围区的代谢物改变特点及其鉴别诊断意义。方法脑肿瘤患者35例,多体素1H-MRS采集NAA、Cho、Cr、Lac、L ip、m I和A la峰,分别计算星形细胞瘤、转移瘤、脑膜瘤的肿瘤强化区、强化周围区和正常参照区域的代谢物浓度,计算不同脑肿瘤、同种脑肿瘤不同区域及高、低级胶质瘤各代谢物比值平均值,比较统计学差异,记录Lac、L ip、m I和A la是否出现。结果肿瘤强化区NAA/Cho、NAA/Cr和Cho/Cr平均值与正常参照区比较均有显著性差异(P<0.05);共出现17例Lac峰、7例L ip峰、6例A la峰和6例m I峰;强化周围区,三者的NAA/Cho、NAA/Cr、NAA/nCr、Cho/NAA值具显著性差异;良、恶性胶质瘤间,NAA/Cho、NAA/nCr、Cho/Cr和Cho/nCho值具有统计学差异(P<0.05)。结论多体素1H-MRS对肿瘤强化周围区域的评价,有助于星形细胞瘤与脑转移瘤、脑膜瘤的鉴别诊断及浸润范围的划定。     

质子磁共振波谱在脑肿瘤中的应用研究

目的 研究脑肿瘤质子磁共振波谱的不同表现及其临床应用价值。材料与方法 搜集行质子磁共振波检查并经病理追踪证实的65例脑肿瘤患者,其中Ⅰ-Ⅱ级星形细胞瘤12例,Ⅲ级星形细胞瘤6例,成胶质细胞瘤8例,胶质瘤术后复发4例,脑膜瘤9例,转移瘤17例,神经鞘瘤4例,垂体瘤4例,表皮样囊肿1例;对侧正常相应部位作为自身对照组20例。观察定点分辨选择波谱（PRESS）采集N－乙酰天门冬氨酸（STEAM）对脂质（Lip)、丙氨酸（ Ala)等短T2代谢物的显示。结果 同对照组比较脑肿瘤NAA有不同程度下降（P＜0．05）;脑外肿瘤NAA低于脑内肿瘤,脑膜瘤NAA／Cr,NAA/Cho比Ⅲ级星形细胞瘤低（P＜0．05）;NAA减少在肿瘤中心明显;在肿瘤坏死区及术后残腔几乎测不到NAA。胶质瘤实体部分Cho信号增加（P＜0．005）;成胶质细胞瘤Cho/Cr比Ⅰ－Ⅱ级星形细胞瘤高（P＜0．05）;4例肿瘤复发Cho明显升高。约21．5％的肿瘤显示Lac峰,其中高级别胶质瘤坏死区和术后残腔8例,表皮样囊肿1例,神经鞘瘤囊变区2例,肿瘤水肿区3例。约21％的未经治疗的胶质瘤出现Lip信号;转移瘤9例,脑外肿瘤11例有不同程度的Lip显示。胶质瘤Cr正常和明显减少各半,脑膜瘤Cr低或缺乏。Ala在9例脑膜瘤中有2例显示。结论 ^1HNMRS是研究脑肿瘤物质和能量代谢的有效方法,有助于脑肿瘤的诊断和鉴别诊断,能提供其组织学分级、术后复发、疗效评价等信息。     

Utilization of glutamate/creatine ratios for proton spectroscopic diagnosis of meningiomas

Introduction Our purpose was to determine the potential of metabolites other than alanine to diagnose intracranial meningiomas on proton magnetic resonance spectroscopy (MRS). Methods Using a 1.5-T MR system the lesions were initially identified on FLAIR, and T1- and T2-weighted images. Employing standard point-resolved spectroscopy (PRESS) for single voxel proton MRS (TR 1500 ms, TE 30 ms, 128 acquisitions, voxel size 2 × 2 × 2 cm, acquisition time 3.12 min), MR spectra were obtained from 5 patients with meningiomas, from 20 with other intracranial lesions, and from 4 normal controls. Peak heights of nine resonances, including lipid, lactate, alanine, NAA (N-acetylaspartate), β/γ-Glx (glutamate + glutamine), creatine, choline, myo-inositol, and α-Glx/glutathione, were measured in all spectra. The relative quantity of each metabolite was measured as the ratio of its peak height to the peak height of creatine. Results Relative quantities of α-Glx/glutathione, β/γ-Glx, and total Glx/glutathione were significantly elevated in meningiomas compared to the 20 other intracranial lesions and the normal control brains. Alanine was found in four of five meningiomas, but lactate partially masked the alanine in three meningiomas. None of the other lesions or control brains showed an alanine peak. The one meningioma with no alanine and the three others with lactate had elevated Glx. Conclusion While alanine is a relatively unique marker for meningioma, our results support the hypothesis that the combination of glutamate/creatine ratios and alanine on proton MRS is more specific and reliable for the diagnosis of meningiomas than alanine alone.     

Single voxel proton MR spectroscopy findings of typical and atypical intracranial meningiomas

PURPOSE: To prospectively define proton magnetic resonance spectroscopy (MRS) findings of meningiomas, and describe the ability or inability of short- and long-echo MRS to differentiate typical and atypical meningiomas in vivo. MATERIAL AND METHODS: Seventeen patients with pathologically confirmed typical meningiomas and six with atypical meningiomas were evaluated with conventional MR imaging and MRS before resection. MRS studies using point-resolved spectroscopy (PRESS) localisation, at short- and long-echo time (TR 2000 ms, TE: 30 and 144 ms, 64-96 acquisition) were acquired on a 1.5 T scanner. MRS data obtained from these patients were compared with histopathological findings. Mean cellular proliferation (MIB-1) antibody staining against the Ki-67 antigen was also determined in all meningiomas. RESULTS: Prominent choline (Cho) was present in all meningiomas. Alanine (Ala) was observed in 21 cases of the 23 meningiomas. Acetylaspartate (NAA) and creatine (Cr) were either not observed or detected in minimal amounts in at all both groups of meningiomas on long TE (144 ms) spectra. The mean Cho/Cr values in the four atypical meningiomas were 4.44+/-0.30 (mean+/-standard deviation) and 3.39+/-0.52 in the 12 typical meningiomas on short TE spectra. Cho/Cr ratio could not be determined in the other seven cases because of a lack of creatine peak. Of the five meningiomas in which a lactate peak was detected, four were in typical cases and only one was in atypical meningioma. Mean MIB-1 proliferation index was 3.7% in typical meningiomas and 10% in atypical meningiomas. CONCLUSION: Prominent Cho, absence or low amount of NAA and Cr, and presence of Ala were common characteristics of spectral pattern of both atypical and typical meningiomas on MRS. MRS cannot reliably differentiate typical intracranial meningiomas from atypical meningiomas preoperatively. Mean MIB-1 proliferation index was well correlated with histopathology findings.     

MRS对胼胝体病变的鉴别诊断价值

目的 探讨多体素氢质子磁共振波谱(1H-MRS)对胼胝体病变的鉴别诊断价值.方法 选取17例经临床或病理证实的胼胝体病变患者,其中胼胝体淋巴瘤2例、胼胝体变性4例、胼胝体胶质瘤3例、胼胝体梗死7例、胼胝体多发性硬化1例,研究其病灶MRS特点.结果 2例胼胝体淋巴瘤病灶胆碱(Cho)峰明显升高,肌酸(Cr)及N-乙酰天门冬氨酸(NAA)峰明显降低,并出现高耸的脂质(Lip)峰;4例胼胝体变性患者中2例示Cho/Cr升高,NAA/Cr下降,1例示正常,1例探测到倒置的乳酸(Lac)峰;3例胼胝体胶质瘤病灶NAA峰下降或消失、Cho峰不同程度升高;7例胼胝体梗死均出现明显倒置的Lac峰,NAA不同程度下降;1例多发性硬化患者活动期病灶强化且Cho峰升高,NAA峰降低,并出现倒置的Lac峰,非活动期病灶不强化且MRS基本恢复正常.结论 多体素1H-MRS对胼胝体病变的鉴别诊断有重要的临床应用价值.     

脑膜瘤MR信号特征在诊治中的价值

目的:探讨脑膜瘤的MRI表现与病理学类型、瘤体质地之间的关系。方法:收集术前行MRI检查并经手术病理证实的63例脑膜瘤患者,将其MR信号特征与病理学类型及其瘤体质地的关系进行对照研究分析。结果:5例血管瘤脑膜瘤表现最典型,在T1WI上呈低或稍低信号,在T2WI上呈高信号,质地软。上皮型、纤维型、过渡型二种脑膜瘤在T2WI上有一定的特征性,22例纤维型脑膜瘤17例(77.3%)呈现为低及稍低信号,质地硬,17例上皮型脑膜瘤11例(64.7%)呈现为等信号,质地较硬,过渡型脑膜瘤介于其两者之间。结论:脑膜瘤的T2WI信号特征可在一定程度上反应脑膜瘤病理学类型及瘤体的质地,对指导神经外科医生的制定治疗万案具有重要的参考价值。     

In vivo proton magnetic resonance spectroscopy of intraventricular tumours of the brain

The aim of this study was to assess the usefulness of proton MR spectroscopy in the diagnosis of intraventricular tumours. Fifty-two intraventricular tumours pertaining to 16 different tumour types were derived from our database. All cases had single-voxel proton MR spectroscopy performed at TE at both 30 and 136 ms at 1.5 T. The Mann-Whitney U test was used to search for the most discriminative datapoints each tumour type. Characteristic trends were found for some groups: high Glx and Ala in meningiomas (p < 0.001 and p < 0.01, respectively), high mobile lipids in metastasis (p < 0.001), high Cho in PNET (p < 0.001), high mI + Gly in ependymoma (p < 0.001), high NAC (p < 0.01) in the absence of the normal brain parenchyma pattern in colloid cysts, and high mI/Gly and Ala in central neurocytoma. Proton MR spectroscopy provides additional metabolic information that could be useful in the diagnosis of intraventricular brain tumors. Grants: This work was funded in part by MEDIVO2 (MEC SAF2005–03650), and Generalitat de Catalunya SGR2005–00863 and XT2004–51. CIBER-BBN is an initiative of “Instituto de Salud Carlos III” (ISCiii) of Spain.     

脑星形细胞肿瘤多体素1H-MRS代谢物含量变化及其与Ki-67的相关性

目的:探讨脑星形细胞肿瘤中多体素1H-MRS代谢物含量的变化及其与Ki-67间的相关性。方法:应用SiemensSonata 1.5T超导型MR成像系统对41例脑星形细胞肿瘤患者进行常规MR扫描及MRS检查,其中28例进行了Ki-67抗原指标的免疫组化染色。磁共振波谱分析采用四通道正交头部专用线圈3D-CSI序列扫描,比较分析不同级别星形细胞肿瘤间代谢物情况。用兔抗人Ki-67单克隆抗体测定肿瘤标本的Ki-67抗原标记指数。应用SPSS统计软件进行统计学相关性分析。结果:低级别组脑星形细胞肿瘤多体素?1H-MRS均表现为Cho峰不同程度增高和NAA峰不同程度的降低,5例出现Lac峰,无出现Lip峰。高级别组脑星形细胞肿瘤均表现为Cho峰明显增高,NAA不同程度的明显降低,21例出现Lac峰,11例出现Lip峰。高低级别肿瘤间Cho/Cr,Cho/NAA和Lac/Cr比值有统计学意义的差别。Cho/Cr、Cho/NAA比值与Ki-67指数间均存在明显的相关关系(其相关系数分别为0.640、0.694)。结论:多体素1H-MRS代谢物含量与Ki-67间有良好的相关性,磁共振波谱分析能够为星形细胞肿瘤治疗方案的制定提供更多信息。     

软组织肿瘤良恶性鉴别的术后标本~1H-MRS研究

目的：探讨术后标本1H-MRS鉴别软组织肿瘤良恶性的意义。方法：29例软组织肿瘤术后新鲜标本行常规MRI及1H-MRS测量,比较良、恶性肢体软组织肿瘤在1H-MRS代谢物胆碱（Cho）、肌酸（Cr）、三甲胺（TMA）、N-乙酰天门冬胺酸（NAA）、细胞内脂质IMCL（Lip1）、细胞外脂质EMCL（Lip2）相对浓度（即代谢物峰下平均面积）及Cho/Cr、TMA/Cr、NAA/Cr、Lip1/Cr、Lip2/Cr相对浓度比值,进行差异的t检验。结果：良性软组织肿瘤共11例,各代谢物相对浓度比值之均值分别为TMA/Cr1.02±0.50,Cho/Cr0.98±0.60,NAA/Cr0.46±0.34,Lip1/Cr7.88±6.23,Lip2/Cr5.72±4.46。恶性软组织肿瘤共18例,各代谢物相对浓度比值之均值分别为TMA/Cr2.47±1.04,Cho/Cr2.02±0.72,NAA/Cr0.41±0.39,Lip1/Cr1.41±1.31、Lip2/Cr1.01±0.93。本组资料用于诊断的恶性软组织肿瘤的TMA/Cr、Cho/Cr的阈值分别为1.19和1.21,其准确度分别为96.3%和88.9%,其诊断准确性均位于较高水平。用于诊断的良性软组织肿瘤的Lip1/Cr、Lip2/Cr的阈值分别为2.03和0.82,其准确度分别为90%及80%,其诊断准确性分别位于较高及中等水平。用于诊断的良性软组织肿瘤的NAA/Cr的阈值为0.035,其准确度分别为57%,其诊断价值位于较低水平。结论：Cho/Cr、TMA/Cr、Lip1/Cr、Lip2/Cr比值可作为软组织肿瘤良、恶性程度鉴别诊断的依据。     

复发性脑膜瘤的MRI表现及病理特点研究

目的探讨复发性脑膜瘤的MRI表现及病理特点。资料与方法回顾性分析15例复发性脑膜瘤,对其MRI表现及病理特点进行研究。结果 MRI示复发瘤位于大脑镰旁4例、矢状窦旁1例、蝶骨嵴3例、鞍区3例、小脑幕2例、桥小脑角区1例、枕骨大孔区1例;颅内多发7例,形态不规则或分叶状12例,瘤内囊变坏死8例,脑膜尾征4例,瘤周水肿6例,1例发生C5椎体及椎旁软组织转移;瘤体T1WI为等或稍低信号,T2WI和T2FLAIR为略高信号,增强扫描多为明显的不均匀强化。病理证实:恶性13例,良性2例;连续复发7例;良性肿瘤全切术后,首次复发平均时间为3年,而恶性肿瘤为1.4年,连续复发者首次复发后平均每1～2年肿瘤再次复发;组织学类型改变5例,其中4例从低级别向高级别发展。结论复发性脑膜瘤有独特的MRI表现及病理特点,充分认识并确定其特征性改变,有助于提高诊断的准确率。     

肝脏肿瘤的活体氢质子MR波谱和病理分析

目的 研究活体肝脏氢质子MRS(1H-MRS)评价肝脏局灶性病变的价值.方法 对53例肝肿瘤患者(54个直径＞4 cm的肿瘤)和19名正常志愿者进行1H-MRS检查,分别测量满足诊断需要的正常对照组(17名)和经病理证实的良性肝脏肿瘤组(8例)和肝细胞癌(HCC)组(25例)胆碱I唪/甘油三酯亚甲基峰(Cho/Lip)比值,对结果进行方差分析和两样本间Dunnett-t检验,并通过受试者工作特征(ROC)曲线评价1H-MRS诊断HCC的敏感性和特异性.结果 正常肝脏、良性肿瘤及HCC组的Cho/Lip比值分别为0.07±0.04、0.11±0.06和0.55±0.17(F=6.58,P＜0.05),HCC组高于正常对照组和良性肝脏肿瘤组(t值分别为2.99和2.32,P值均＜0.05),正常肝脏组和良性肿瘤组Cho/Lip比值差异无统计学意义(t=1.53,P＞0.05).ROC曲线下面积为0.77,1H-MRS对诊断HCC有较高诊断价值,当Cho峰与Lip峰比值界值点为0.1时,诊断HCC的敏感性和特异性分别为80.0%和62.5%.结论肝脏局灶性病变1H-MRS分析是可行的,对于鉴别IHCC和良性肝脏肿瘤有一定的临床参考价值.     

Proton MR spectroscopy in neuroborreliosis: a preliminary study

We report results of a magnetic resonance spectroscopy (MRS) study in 12 patients with neuroborreliosis. We used a PRESS sequence, placing an 8 cm³ voxel in normal-appearing white matter of the frontal lobe. Peaks indicating N-acetylaspartate (NAA), choline (Cho), creatine (Cr), myo-inositol (mI), lipids (Lip) and lactate (Lac) were identified and ratios of NAA/Cr, Cho/Cr, mI/Cr, Lip/Cr, Lac/Cr calculated. Significant increases in Cho/Cr and Lip/Cr were noted. No abnormality was found in mean NAA/Cr and Lac/Cr, but in four patients there was a decreased NAA peak; mI/Cr ratio was slightly increased. Although the spectroscopic profile in patients with neuroborreliosis seems to be nonspecific, MRS might be useful for assessing tissue damage of the central nervous system.     

磁共振常规成像及DWI对脑膜瘤的诊断价值

目的:比较磁共振常规成像序列(T1WI、T2WI及FLAIR)与DWI对脑膜瘤的检出率,探讨其鉴别病理亚型及良恶性的价值。方法:回顾性分析70例经手术病理证实的脑膜瘤患者的MRI图像,计算不同序列对脑膜瘤的检出率;测量并比较不同病理亚型、不同病理分级的肿瘤实质的平均ADC值和相对ADC值(rADC值)。结果:在T2WI上出现低信号的多是纤维型、过渡型和砂粒体型,出现高信号的多是脑膜上皮型和血管瘤型。在各个序列中,以DWI对脑膜瘤病变的检出率最高(87.1%),T2WI次之(74.3%),T1WI最低(38.6%)。恶性脑膜瘤的囊变发生率(67%)明显高于良性脑膜瘤(22%)。良性组各亚型间、良恶性两组间平均ADC值及rADC值差异均无统计学意义(P>0.05)。结论:DWI可提高对脑膜瘤的检出率,但单独根据ADC值并不能鉴别脑膜瘤的亚型及良恶性。DWI结合常规MRI表现对脑膜瘤亚型及良恶性的鉴别有一定意义。     

Preoperative subtyping of meningiomas by perfusion MR imaging

Introduction  This paper aims to evaluate the value of perfusion magnetic resonance (MR) imaging in the preoperative subtyping of meningiomas by analyzing the relative cerebral blood volume (rCBV) of three benign subtypes and anaplastic meningiomas separately. Materials and methods  Thirty-seven meningiomas with peritumoral edema (15 meningothelial, ten fibrous, four angiomatous, and eight anaplastic) underwent perfusion MR imaging by using a gradient echo echo-planar sequence. The maximal rCBV (compared with contralateral normal white matter) in both tumoral parenchyma and peritumoral edema of each tumor was measured. The mean rCBVs of each two histological subtypes were compared using one-way analysis of variance and least significant difference tests. A p value less than 0.05 indicated a statistically significant difference. Results  The mean rCBV of meningothelial, fibrous, angiomatous, and anaplastic meningiomas in tumoral parenchyma were 6.93 ± 3.75, 5.61 ± 4.03, 11.86 ± 1.93, and 5.89 ± 3.85, respectively, and in the peritumoral edema 0.87 ± 0.62, 1.38 ± 1.44, 0.87 ± 0.30, and 3.28 ± 1.39, respectively. The mean rCBV in tumoral parenchyma of angiomatous meningiomas and in the peritumoral edema of anaplastic meningiomas were statistically different (p < 0.05) from the other types of meningiomas. Conclusion  Perfusion MR imaging can provide useful functional information on meningiomas and help in the preoperative diagnosis of some subtypes of meningiomas.     

囊性脑膜瘤的影像学与病理学诊断（附21例分析）

目的：探讨囊性脑膜瘤的临床表现、影像学和病理学特点。方法：回顾性分析21例临床上少见的囊性脑膜瘤的影像学和病理学表现。结果：21例患者肿瘤全切除14例,次全切除7例。结论：CT、MRI对诊断囊性脑膜瘤很有价值,依据囊性脑膜瘤的病理特征,将其分为真性囊性脑膜瘤和假囊性脑膜瘤。肿瘤因囊肿形成,病情发展迅速,常引起严重的临床症状,极易误诊为其他性质的病变。本文对其临床病理诊治经验进行了探讨。     

Studying neonatal bilirubin encephalopathy with conventional MRI,MRS, and DWI

Introduction  The purpose of this study was to evaluate the diagnostic value of conventional magnetic resonance imaging (MRI), proton magnetic resonance spectroscopy (¹H-MRS), and diffusion-weighted imaging (DWI) for neonatal bilirubin encephalopathy. Methods  We collected conventional MRI in 24 neonates with neonatal bilirubin encephalopathy. We performed ¹H-MRS and DWI sequences to nine of the 24 patients and seven age-matched healthy control subjects. Multiple-voxel ¹H-MRS data were acquired using PRESS pulse sequence with TE = 135 ms and TR = 1500 ms. The spectroscopic regions of interest were the bilateral basal ganglia and thalamus with a 1.0 mL spatial resolution. The data from DWI were collected by using a single shot-spin echo-echo planar imaging sequence with TR/TE: 2900/98, and imaging regions were also focused on the bilateral basal ganglia and thalamus. Results  Nineteen of the 24 patients had abnormal T₁-weighted image hyperintensity in the globus pallidus, but these lesions appeared as normal T₂-weighted image intensity in the same region. Ten of the 24 patients had T₁-weighted image high signal intensity in the subthalamic nucleus and appeared as normal intensity in the region for the T₂-weighted images. The peak area ratios of NAA/Cho and NAA/Cr were significantly decreased (t-test, P < 0.05) in the patients compared to the controls in the basal ganglia. Conclusion  Conventional MR imaging and ¹H-MRS are important complementary tools in the diagnosis of neonatal bilirubin encephalopathy. The study provides important information for applying these MR modalities to evaluate neonates with bilirubin encephalopathy.     

骨与软组织肿瘤的磁共振氢质子波谱分析

目的探讨磁共振氢质子波谱(1H-MRS)是否有助于四肢骨与软组织良恶性肿瘤的诊断及鉴别。方法对5例肢体正常骨与肌肉组织、23例四肢肿瘤进行1H-MRS检查,应用8通道相控阵线圈,并采用单体素波谱(SVS)的点分辨表面定位序列(PRESS):TE35、144ms和288ms。结果四肢骨与软组织良、恶性肿瘤和正常组织的1H-MRS波谱明显不同,恶性肿瘤的胆碱(Cho)含量明显升高。结论应用1H-MRS可以在骨与软组织恶性肿瘤中检测到明显升高的胆碱,可以作为临床良恶性肿瘤诊断、鉴别及指导治疗的重要手段。