3．0T磁共振多体素^1H-MRS和DWI对常见脑肿瘤特征分析的价值

目的：探讨3．0T磁共振多体素^1H-MRS及DWI在常见颅内肿瘤特征分析的价值。方法：脑肿瘤患者30例，多体素^1H-MRS感兴趣区包括肿瘤实质区、瘤周水肿区及正常参照区。计算上述各区域的NAA、Cho、Cr等多种代谢物的值；DWI测量肿瘤不同部位信号值，计算ADC值。结果：胶质瘤、转移瘤、脑膜瘤三者之间肿瘤实质区的NAA／Cho、NAA／Cr和Cho／Cr平均值与参照区比较有显著性差异（P〈0．05）；高、低级别胶质瘤间瘤周水肿区的NAA／Cho和Cho／Cr具有统计学差异（P〈0．05），高级别胶质瘤与转移瘤间瘤周水肿区的NAA／Cho、NAA／Cr和Cho／Cr均有统计学差异（P〈0．05）。DWI示高、低级别胶质瘤间肿瘤实质区及瘤周水肿区的ADC值均有显著性差异（P〈0．05）；高级别胶质瘤与转移瘤间瘤周水肿区的ADC值有统计学差异（P〈0．05）。结论：多体素^1H-MRS与DWI相结合有助于脑肿瘤的特征分析、胶质瘤恶性程度分级、确定病灶浸润范围等。

Value of 3.0 tesla multivoxel 1 H-magnetic resonance spectroscopy and diffusion-weighted imaging in characterization of cerebral neoplasms

Objective：To investigate the value of multivoxel proton magnetic resonance speetroseopy（^1H-MRS） and diffusion weighted imaging（DWI） in characterization of brain tumors. Methods：Tlfirty intracranial tumor patients were recruited in dais study. Regions of interests included solid areas, edema areas and control areas. NAA, Cho, Cr and other metabolite peaks were measured from above regions, and NAA/Cho, NAA/Cr, Cho/Cr ratios were calculated for each voxel. The ADC values were calculated from various areas and the difference of the mean ADCs were analyzed. Results： The ratios of NAA/Cho, NAA/Cr and Cho/Cr from enhanced areas of the lesion showed significant differences when compared with that of normal brain tissues（ P 〈 0.05）. In voxels of edema from peritumor regions, the ratios of NAA/Cho and Cho/Cr splid high and low grade gliomas presented significant differences（ P 〈 0.05）, meanwhile the ratios of NAA/Cho, NAA/Cr and Cho/Cr between high grade gliomas and metastases revealed significant differences（ P 〈 0.05）. The mean ADCs from solid areas of brain tumors were significantly different between high and low grade gliomas. The ADC values of peritumor between high and low grade gliomas, and between high grade gliomas and metastases were statistically different. Conclusion： Muhivoxel ^1H- MRS and DWI provide quantitative data to characterize brain tumcrs, contribute to grading gliomas and help to evaluate the margin of tumors.