~1H-MRS在胶质母细胞瘤周围区的应用研究

目的:评价2D多体素磁共振氢质子波谱成像技术(1 H-MRS)在胶质母细胞瘤周围区中的应用价值。方法:对30例胶质母细胞瘤患者行常规MRI及1 H-MRS检查,所有患者均行增强扫描。测量肿瘤周围区(包括水肿区及瘤周显示正常区域)的Cho/Cr、Cho/NAA、NAA/Cr的比值,并且计算瘤周显示正常区域的NAA/nCr的比值,将以上值与对侧正常区域的相应比值进行两样本配对t检验,分析其差异是否有统计学意义。结果:肿瘤周围水肿区及瘤周显示正常区的Cho/Cr、Cho/NAA的比值较对侧明显升高,差异有统计学意义(P<0.05)。肿瘤周围水肿区的NAA/Cr值较对侧降低且差异有统计学意义(P<0.05);肿瘤周围显示正常区的NAA/Cr值较对侧亦有降低,但差异无统计学意义(P>0.05),瘤周显示正常区NAA/nCr值较对侧明显降低,差异有统计学意义(P<0.05)。结论:2D多体素1 H-MRS成像技术对肿瘤周围区代谢物变化的检测可为推断胶质母细胞瘤瘤周区肿瘤细胞的浸润范围提供依据。

1H-MRS in peritumoral region of glioblastoma

Objective：To evaluate the value of multi-voxel magnetic resonance spectroscopy （1 H-MRS） in the peritu- moral region of glioblastoma. Methods：Thirty patients with glioblastoma underwent conventional MRI,1H-MRS and con- trast-enhanced MRI before surgical resection. Metabolite ratios of Cho/Cr, Cho/NAA NAA/Cr in areas of edema region ad- jacent to tumors and NAA/nCr in normal-appearing region were obtained respectively. The student t test was used to deter- mine if there was a statistically significant difference in metabolic ratios between edema region and normal-appearing region adjacent to tumor （and contralateral normal-appearing region）. Results：Cho/Cr,Cho/NAA in edema region and normal-ap- pearing region adjacent to the tumors were higher than those in contralateral normal region, and there were significant differences between them （P~0.05）. NAA/Cr in edema region were lower than those in contralateral normal region, and showed significant differences between them （P＇~O. 05）. NAA/Cr in normal-appearing region adjacent to the tumors were lower than those in contralateral normal region, but there were no significant differences between them （P~0.05）, while NAA/nCr in normal-appearing region adjacent to the tumors were lower than those in contralateral normal region （P~ 0.05）. Conclusions：1 H-MRS may be helpful for evaluating infiltrating tumor cells that usually invade along the white matter tracts in peritumoral edema of glioblastoma.