氢质子波谱分析对胶质瘤分级及瘤周浸润的应用价值

目的探测多体素1H波谱分析对胶质瘤分级及瘤周浸润情况的应用价值。方法选取32例经病理证实为胶质瘤且作常规MRI及MRS检查之患者,低级别（WHO分级的Ⅰ或Ⅱ级）的有12例,高级别（WHO分级的Ⅲ或Ⅳ级）的共计20例。分别测量不同级别胶质瘤肿瘤实质区、周围区代谢物比值：NAA/Cho及Cho/Cr值,观察有无差异性。结果不同级别胶质瘤之间,肿瘤实质区及周围区的NAA/Cho及Cho/Cr比值有统计学差异（P〈0.05）。随着胶质瘤级别的升高,肿瘤实质区及周围区NAA/Cho比值降低,Cho/Cr比值升高。结论不同级别胶质瘤肿瘤实质区、周围区NAA/Cho及Cho/Cr均存在统计学差异,波谱分析对判定胶质瘤级别和瘤周浸润情况具有一定价值。

Value of Proton-related Spectral Analysis in Tumor Grade and Infiltration of Glioma

Objective To study the value of multi-voxel magnetic resonance spectroscopy in tumor grade and infiltration of glioma by measuring metabolites in the real terms and in the surrounding areas of glioma.Methods Thirty-two cases of patients suspected of glioma were examinated by conventional MRI and MRS.Of these cases,eleven cases were lower-grade malignant gliomas（equivalent to WHO classification grade Ⅰ or Ⅱ）,twenty-one cases were higher-grade malignant gliomas（equivalent to WHO classification grade Ⅲ or Ⅳ）.By measuring the real terms and the surrounding areas of tumor,metabolite ratios（NAA/Cho;; Cho/Cr;）were compared among different grade gliomas.Results Between higher-grade and lower-grade malignant gliomas,NAA/Cho,Cho/Cr of the real terms and the surrounding areas changed with significant difference （P〈0.05）.With the increased level of glioma,NAA/Cho of the real terms and the surrounding areas became lower,Cho/Cr became higher.Conclusion By measuring the metabolite ratios of the real terms and the surrounding areas of glioma,we can evaluate the tumor grade and infiltration of glioma.