磁共振波谱成像结合扩散加权成像在脑胶质瘤及脑转移瘤鉴别诊断中的意义

目的:评估磁共振波谱成像(Proton Magnetic Resonance Spectroscopy,1H-MRS)联合磁共振扩散加权成像(Diffusion Weighted Imaging,DWI)在鉴别脑胶质瘤及孤立的脑转移瘤中的作用。方法:应用3.0T磁共振扫描仪,对临床手术确诊及组织病理学诊断证实的49例脑肿瘤患者(35例多形性胶质母细胞瘤,14例脑转移瘤)进行常规磁共振成像、磁共振波谱成像及磁共振扩散加权成像,并并对获得的数据进一步测量瘤内及瘤周区的代谢比、N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)值以及表观弥散系数(ADC值),分析两肿瘤组之间不同参数的统计学差异。此外,我们研究了感兴趣区域(ROI)的大小对肿瘤区域的病变扩散性能潜在影响。结果:胶质母细胞瘤瘤周N-乙酰天门冬氨酸(NAA)、肌酸(Cr),胆碱(Cho)/Cr,Cho/NAA和r CBV显著高于颅内转移瘤(P0.05);ADC值在两肿瘤组之间无显著差异(P0.05)。结论:在瘤周区1H-MRS有助于鉴别胶质母细胞瘤与单发的脑转移瘤。在瘤内扩散性的定量特性依赖ROI大小的设置。

Magnetic Resonance Imaging Combined with Diffusion Weighted Imaging in Tumor Differential Diagnosis of Brain Glioma and Brain Metastases

Objective:To evaluate magnetic resonance spectroscopy (Proton Magnetic Resonance Spectroscopy, 1H-MRS) combined with magnetic resonance diffusion weighted imaging (Diffusion Weighted, Imaging, DWI) in the aneurysm role identification of gliomas and solitary brain metastases.Methods:using 3.0T magnetic resonance scanner, 49 cases of patients with brain tumor confirmed by operation and clinical diagnosis of pathological diagnosis (35 cases of glioblastoma, 14 cases of brain metastases) were performed magnetic resonance imaging, magnetic resonance spectroscopic imaging and diffusion weighted magnetic resonance imaging, and the data was obtained for further measurement of intratumoral and peritumoral region of metabolic ratio, N-acetyl aspartic acid (NAA), choline (Cho), creatine (Cr) values and apparent diffusion coefficient (ADC value), analysis was performed to different parameters of the statistical difference between the two tumor group. In addition, we study the region of interest (ROI) performance potentially influence the size of the diffusion of the tumor region lesions.Results:Glioblastoma peritumoral N- acetyl aspartic acid (NAA), creatine (Cr), choline (Cho) /Cr, Cho / NAA and rCBV were significantly higher than that in intracranial metastases (P<0.05); the ADC value had no significant difference between the two tumor group (P>0.05).Conclusion:there are helpful in the differential diagnosis of glioblastoma and solitary brain metastases peritumoral region in 1H-MRS. The quantitative characteristics of diffusion in tumor size dependent ROI settings.