MRS及DWI在脑胶质瘤中的应用价值

目的 探讨磁共振扩散加权成像（DWI）和1H-磁共振波谱（1H -MRS）在诊断脑胶质瘤及评价其分级中的作用.方法 选取80例脑胶质瘤患者进行DWI及MRS检查,通过测定脑肿瘤实质部分、对照正常侧的ADC值及比值（rADC）、N-乙酰天门冬氨酸（NAA）、胆碱（Cho）、肌酸（cr）水平及其比值,结合患者术后病理学检查结果,分析磁共振扩散加权成像（DWI）表观弥散系数（ADC）值和1H -磁共振波谱（1H -MRS）在诊断脑胶质瘤及其分级中的作用.结果 （1）高级别组患者ADC值与rADC值均显著低于低级别组,相关分析发现ADC值与rADC值与肿瘤级别呈负相关;（2）与低级别组相比,高级别组患者NAA/Cho、NAA/Cr显著降低,Cho/Cr值显著升高,差异有统计学意义（P＜0.05）.相关分析显示NAA/Cho、NAA/Cr与肿瘤级别呈负相关,Cho/Cr与肿瘤级别呈正相关.结论 通过检测rADC值、NAA/Cho、NAA/Cr、Cho/Cr的变化,可以评价低级别及高级别的脑胶质瘤,为术前分级提供重要的指导.

Application value and pathological correlation of MRS and DWI in the diagnosis of cerebral glioma

Objective To study the application value and pathological correlation of MRS and DWI in the diagnosis of cere- bral glioma. Methods A Total of 80 patients with cerebral glioma underwent DWI and MRS examination, ADC values, rADC values,NAA,Cho,Cr levels and the ratio were measured, according to the pathological results, the value of ADC value and MRS in the diagnosis of glioma and the correlation with pathology were observed. Results The ADC value and rADC value of the high-level group was significantly lower than the low-level group, and correlation analysis found ADC value, rADC value had negatively correlated with tumor grade （ r =- 0. 756, -0. 789, P 〈0.05 ）. Compared with low-level group, NAA/Cho, NAA/Cr of high-level group significantly reduced while the Cho/Cr values were significantly increased （P%0.05）. The correlation analysis showed that NAA/Cho, NAA/Cr had negatively correlated with tumor grade （r=-0. 819 ,-0. 745,P〈0.05）. Cho/Cr had positively correlated with tumor grade （r=0. 834,P〈0.05）. Conclusion by detecting rADC value, NAA/Cho, NAA/Cr, Cho/Cr, we can distinguish between low-grade and high-grade tumors, so they have high value in preoperative grading.