氢质子磁共振波谱在颅内常见肿瘤诊断中的应用价值

目的： 通过氢质子磁共振波谱（H-MRS）方法分析颅内常见肿瘤组织与正常脑组织及脑肿瘤间代谢物差别，探讨H-MRS对颅内常见肿瘤的诊断价值。方法：对经临床手术证实的27例Ⅰ-Ⅱ级胶质瘤、22例Ⅲ-Ⅳ级胶质瘤、24例脑转移瘤和21例脑膜瘤的H-MRS图像进行分析，得到N-乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱复合物（Cho）和乳酸（Lac）的峰值高度并计算NAA/Cr、Cho/Cr、NAA/Cho比值，比较各组数据。结果：颅内肿瘤常规MRI检查结果表现各异，难以鉴别；颅内肿瘤组织H-MRS与正常脑组织比较NAA降低(P<0.01),Cho升高(P<0.05)，且胶质瘤实质强化区的NAA/Cr比值与脑膜瘤、转移瘤相比具有明显差异(P<0.05)。结论： H-MRS可以在分子水平上对颅内肿瘤进行鉴别诊断，可以在临床上弥补常规MRI影像的不足；H-MRS检查可为病理分级、制定合理的治疗方案提供有价值的影像信息。

Application of ~1H-MRS in diagnosis of common intracranial tumors

Objective To discuss the value of ~1H-MRS in diagnosis of common intracranial tumors by analyzing the metabolism differences between common intracranial tumors and normal brain tissue, and those among different intracranial tumors with ~1H-MRS. Methods ~1H-MRS manifestations of 27 cases of I-II grade glioma, 22 cases of III-IV grade glioma, 24 cases of metastasis and 21 cases of meningioma were analyzed retrospectively, the peak values of N-acetylaspartate (NAA), creatine (Cr), choline (Cho) and lactate (Lac) were detected, the ratios of NAA/Cr, Cho/Cr, and NAA/Cho were compared. Results There were no significant differences among common intracranial tumors in routine MRI examination, and the ~1H-MRS manifestations of intracranial tumors were obviously different with that of normal brain tissue: NAA was decreased (F<0. 01), Cho was increased (P< 0.05), and the NAA/Cr ratio in the region of glioma enhancement was obviously different with those of meningioma and metastasis (P<0. 05). Conclusion ~1H-MRS could distinguish different kinds of intracranial tumors in molecular level, so it can make up the defect of routine MRI.~1H-MRS can provide useful image information in intracranial tumors for pathologic classification and regulating reasonable treatment principles.