鼻咽癌多体素氢质子磁共振波谱的表现及其临床价值

目的探讨鼻咽癌多体素氢质子磁共振波谱的表现及其临床价值。方法选择2010年2月～2013年2月在浙江大学医学院附属第二医院收治的鼻咽癌患者110例（观察组），另选择同期来该院行健康体检的100例健康体检者（正常组），利用1．5T symphony超导型磁共振成像机行头颈部波谱扫描，记录并分析结果。将观察组的图像观察兴趣区分为瘤体区、瘤周区、对照区，观察其波谱图的变化状态。同时记录N-乙酰天门冬氨酸（NAA）、胆碱（Cho）和肌酸（Cr）等代谢物波峰值。计算三区域的NAMCho、NAA／Cr及Cho／Cr等比值。结果T2WI及多体素氢质子磁共振波谱显示：正常组颌面部肌肉在81．0～1．4处可见宽大的脂质峰；观察组在83．0～3．6可见宽大的脂质峰，体素大小为1．6～11．5cm＾3，平均（4．9±0．4）cm＾3。观察组对照区NAMCho、NAMCr均明显高于瘤体区、瘤周区，差异均有统计学意义（P＜0．05），Cho／Cr明显低于瘤体区、瘤周区，差异有统计学意义（P＜0．05）；三个区域NAA／Cho、NAMCr、Cho／Cr比较差异有统计学意义（P＜0．05）。结论Cho／Cr比值可以作为鼻咽癌诊断的标准之一。

Expression and clinical value of 1H-MRS for nasopharyngeal carcinoma

Objective To explore the expression and its clinical value of 1H-MRS for nasopharyngeal carcinoma. Methods From February 2010 to February 2013, in the Second Hospital Affiliated to Zhejiang University School of Medicine, 110 patients with nasopharyngeal carcinoma were chosen as the observation group, at the same time, 100 healthy people with physical examination in this hospital were chosen as normal group, 1.5T symphony type supercon- ducting magnetic resonance imaging on the research object line of head and neck spectrum scanning was used, the re- salts were recorded and analyzed. In the observation group, interest in the image observation area was divided into tumors area, week of tumor area and control area for three different areas, change of the spectrum on the spectrogram was observed. The corresponding PPM position for N-acetyl aspartic acid （NAA）, choline （Cho） and ereatine （Cr）, and other metabolites crest value were recorded, and input into SAS statistical software package. Tumor entity, tumor weeks respectively calculated area and control area NAA/Cho, NAA/Cr, Cho/Cr ratio, etc were counted. Results T2WI 1H-MRS showed： in normal group the maxillofacial muscles at 81.0-1.4 was wide lipid peak; in observation group that at 83.0- 3.6 with wide was lipid peak, voxel size was 1.6-11.5 cm3, with average of （4.9±0.4） cm3. In observation group, the control area NAA/Cho, NAA/Cr were significantly higher than that of tumors, tumor weeks district, the difference was statistically significant （P 〈0.05）, Cho/Cr was significantly lower than that of the week of tumors, tumor area, the difference was statistically significant （P 〈0.05）. Three regional comparison between groups, the differences of NAA/Cho, NAMCr, Cho/Cr were statistically significant （P 〈0.05）. Conclusion Cho/Cr ratio can be used as one of the standard for diagnosis of nasopharyngeal carcinoma.