Role of Quantitative Magnetic Resonance Imaging Parameters in the Evaluation of Treatment Response in Malignant Tumors

Objective:

To elaborate the role of quantitative magnetic resonance imaging (MRI) parameters in the evaluation of treatment response in malignant tumors.

Data Sources:

Data cited in this review were obtained mainly from PubMed in English from 1999 to 2014, with keywords “dynamic contrast-enhanced (DCE)-MRI,” “diffusion-weighted imaging (DWI),” “microcirculation,” “apparent diffusion coefficient (ADC),” “treatment response” and “oncology.”

Study Selection:

Articles regarding principles of DCE-MRI, principles of DWI, clinical applications as well as opportunity and aspiration were identified, retrieved and reviewed.

Results:

A significant correlation between ADC values and treatment response was reported in most DWI studies. Most quantitative DCE-MRI studies showed a significant correlation between K^trans values and treatment response. However, in different tumors and studies, both high and low pretreatment ADC or K^trans values were found to be associated with response rate. Both DCE-MRI and DWI demonstrated changes in their parameters hours to days after treatment, showing a decrease in K^trans or an increase in ADC associated with response in most cases.

Conclusions:

Combinations of quantitative MRI play an important role in the evaluation of treatment response of malignant tumors and hold promise for use as a cancer treatment response biomarker. However, validation is hampered by the lack of reproducibility and standardization. MRI acquisition protocols and quantitative image analysis approaches should be properly addressed prior to further testing the clinical use of quantitative MRI parameters in the assessment of treatments.     

Coronal Diffusion-weighted Magnetic Resonance Imaging of the Kidney: Agreement with Axial Diffusion-weighted Magnetic Imaging in Terms of Apparent Diffusion Coefficient Values

Background:

Coronal diffusion-weighted magnetic resonance imaging (DW-MRI) and apparent diffusion coefficient (ADC) values have gradually become applied (following conventional axial DW-MRI) in the renal analysis. To explore whether data obtained using coronal DW-MRI are comparable with those derived using axial DW-MRI, this preliminary study sought to assess the agreement in renal ADC values between coronal DW-MRI and axial DW-MRI.

Methods:

Thirty-four healthy volunteers were enrolled in the study; written consents were obtained. All subjects underwent respiratory-triggered axial and coronal DW-MRI using a 1.5-MR system with b values of 0 and 800 s/mm². The signal-to-noise ratios (SNRs) of the two DW-MRI sequences were measured and statistically compared using the paired t-test. The extent of agreement of ADC values of the upper pole, mid-pole, and lower pole of the kidney; the mean ADC values of the left kidney and right kidney; and the mean ADC values of the bilateral kidneys were evaluated via calculation of intraclass correlation coefficients (ICCs) or Bland–Altman method between the two DW-MRI sequences.

Results:

The SNR of coronal DW-MR images was statistically inferior to that of axial DW-MR images (P < 0.001). The ICCs of the ADC values of each region of interest, and the mean ADC values of bilateral kidneys, between the two sequences, were greater than 0.5, and the mean ADCs of the bilateral kidneys demonstrated the highest ICC (0.869; 95% confidence interval: 0.739–0.935). In addition, 94.1% (32/34), 94.1% (32/34), and 97.1% (31/34) of the ADC bias was inside the limits of agreement in terms of the mean ADC values of the left kidneys, right kidneys, and bilateral kidneys when coronal and axial DWI-MRI were compared.

Conclusions:

ADC values derived using coronal DW-MRI exhibited moderate-to-good agreement to those of axial DW-MRI, rendering the former an additional useful DW-MRI method, and causing the ADC values derived using the two types of DW-MRI to be comparable.     

MR扩散加权成像对乳腺良恶性病变诊断价值

目的探讨MR扩散加权成像及表观扩散系数（ADC值）对乳腺良恶性病变的诊断价值。方法对77例女性乳腺患者行MRI—DWI（b=500、800s／mm2）检查,相同的感兴趣区（ROI）下,测量病变的ADC值,结果进行统计学分析,所有病变均经手术及病理证实。结果b值分别取5OO、800s／mm2,乳腺良恶性病变的ADC值差异均有统计学意义（t=7．027,P〈0．001;t=6．399,P〈0．001）;b-500s／mm2,最佳诊断点ADC值为1．13×10-3mm2／S ROC曲线下面积为0．90,灵敏度为90．7％,特异度为79．4％;b=800s／mm2,最佳诊断点ADC值为1．03×10-3mm2／S,ROC曲线下面积为0．88,灵敏度为81．4％,特异度为88．2％。结论MR扩散加权成像及ADC值对乳腺良恶性病变诊断有重要价值。     

Comparison of Magnetic Resonance Elastography and Diffusion-weighted Imaging for Staging Hepatic Fibrosis

Background:

To compare the diagnostic values of magnetic resonance elastography (MRE) and diffusion-weighted imaging (DWI) in staging hepatic fibrosis (HF) in an animal model.

Methods:

This study consisted of 44 rabbits served as HF group and 9 normal rabbits. HF group was divided into two subgroups: Group A (n = 32) and Group B (n = 12). Rabbits in Group B were served as a complementary group when rabbits in Group A suddenly died during the study. Rabbits from control and Group A underwent abdominal MR imaging (MRI), MRE, and DWI. In Group A, random eight rabbits underwent MRI examinations at 4, 5, 6, 10 weeks after carbon tetrachloride oil subcutaneous injection. Liver stiffness (LS) and apparent diffusion coefficient (ADC) values of liver parenchyma were measured. The diagnostic performance of MRE and DWI for staging HF was compared using the receiver operating characteristic curve analysis on the basis of the histopathological analysis of HF.

Results:

Significant differences of LS and DWI values were present among HF stages (P < 0.005). The LS values measured on MRE (r = 0.838, P < 0.001) were more strongly correlated with the HF stages than with ADC values (r = −0.527, P < 0.001). The area under the receiver operating characteristic curve values of LS were significantly larger than those of DWI were for discriminating two stages of HF (0.979 vs. 0.712 for ≥ S1, 0.922 vs. 0.699 for ≥ S2). MRE showed higher specificity for predicting all stages of HF compared to DWI.

Conclusions:

MRE more strongly correlated with the HF stages than DWI and is more specific in predicting all HF stages.     

前列腺癌磁共振动态增强联合波谱成像的诊断价值

目的分析前列腺癌的磁共振波谱成像(~1H-MRS)及动态增强磁共振成像(DCE-MRI)表现,探讨~1H-MRS及DCE对前列腺癌的诊断价值。方法回顾性分析26例前列腺癌(Pca)及32例前列腺增生(BHP)的MR征象,全部患者行MRS及DCE检查,分析病例的MRS及DCE图像,测量Pca及BHP的(Cho+Cr)/Cit值。DCE共采集37次图像,分析Pca及BHP的SI-T曲线变化规律。结果在DCE-MRI检查中前列腺癌都表现为比正常的前列腺组织明显早期强化,26例PCa病人SI-T曲线24例表现为III型,2例表现为II型曲线,32例BPH病人SI-T曲线16例表现为I型曲线,8例表现为II型曲线,8例表现为III型曲线,DCE-MRI诊断的敏感性、特异性及准确率分别能达到92%、75%,82%;Pca患者中有4例(Cho+Cr)/Cit0.99,22例(Cho+Cr)/Cit0.99,BPH组有8例(Cho+Cr)/Cit0.99,24例(Cho+Cr)/Cit0.99,MRS诊断的敏感性、特异性及准确率分别能达到85%、89.1%,86%。结论 DCE-MRI对Pca敏感度较高,特异度较低,而~1H-MRS对Pca敏感性较低,联合~1H-MRS的量化指标与DCEMRI图像表现的SI-T曲线可提高前列腺癌诊断的正确率,并且可以直观显示病变部位、范围及转移情况,结合常规MRI对Pca进行准确的诊断和分期评估。     

MR-DWI在诊断椎体良恶性压缩骨折应用的研究

目的探讨采用磁共振(MR,Magnetic resonance)弥散加权成像(DWI,Diffusion-Weighted Imaging)和表观弥散系数(ADC,Apparent diffusion coefficien)诊断椎体压缩骨折良恶性方面的应用价值。方法对25例健康志愿者和89例椎体压缩骨折患者的MRI常规序列及DWI的影像资料统计学分析。结果 1、通过DWI信号强弱判断椎体病变的良恶性方面没有统计学意义p=0.083(p>0.05);2、在b=400s/mm2时,只是感染性病变和恶性肿瘤分别所致的压缩骨折的ADC值比较,无统计学意义(p=0.093,p>0.05),而其余各组之间的ADC差异均具有统计学意义;3、采用常规MRI和采用常规MRI联合DWI时,在诊断椎体病变方面有显著差异,P=0.048(P<0.05)。结论通过DWI成像技术和测量ADC值,可做为鉴别椎体压缩骨折的良恶性一种新的诊断途径和标准;常规MRI序列与DWI技术相结合具有敏感度高、特异度强,在临床诊断中有应用价值。     

MRI平扫与增强扫描诊断嗅神经肿瘤的影像学特征分析

目的探讨嗅神经肿瘤(olfactory nerve tumor,ONB)的MRI影像学表现及临床特点,用以指导临床诊断。方法回顾分析2009年9月至2011年9月经手术病理证实的10例ONB患者,所有患者均进行MRI平扫和增强扫描,分析其临床特点及影像学表现。结果 10例患者中的9例患者的MRI平扫结果显示为T1WI上低信号软组织影,T2WI上高信号影,确诊率高达90%。10例患者的MRI增强扫描结果显示肿块明显不均匀强化,部分鼻副窦粘膜有强化,确诊率高达100%,MRI增强扫描的确诊率高于MRI平扫,诊断结果与临床病理确认结果相比,差异无统计学意义(P0.05)。结论 MRI影像分析可以清楚显示肿瘤所在部位及侵犯范围,在嗅神经肿瘤的诊断中具有非常高的应用价值,可以作为嗅神经肿瘤的重要检查方法。     

扩散加权成像鉴别肺部良恶性病变的价值

目的探讨扩散加权成像(diffusion-weightedimaging,DWI)对肺部实性良性病变与恶性肿瘤鉴别诊断价值。方法对77例经病理或临床证实的肺内实性良性病变与恶性肿瘤行常规MRI和DWI检查,b值为0,500s/mm2,测量病变DWI信号强度(SignalintensitySI)值、同层胸壁肌肉DWI信号强度(SI)值及病变的表观扩散系数(apparentdiffusioncoefficient,ADC)值,同时计算病变SI与胸壁肌肉SI的比值(LMR)。结果 (1)肺部良性病变组和恶性病变组的ADC值分别为(1.663±0.443)×10-3mm2/s(,1.203±0.234)×10-3mm2/s,,两者差异有统计学意义(t=-5.981,P=0.000);良恶性病变ADC值的ROC曲线下面积为0.827,诊断阈值为1.492×10-3mm2/s,敏感度为94.1%,特异度为73.1%。(2)肺部良恶性病变的SI、LMR虽有一定差异,但无特征性,无临床意义。结论 ADC值有助于鉴别肺部良恶性病变,它可能成为鉴别诊断的一种新方法。     

DWI联合DCE-MRI在诊断鉴别乳腺非肿块样病变中的应用

目的研究弥散加权成像(DWI)联合动态增强扫描(DCE-MRI)在诊断鉴别乳腺非肿块样病变中的应用价值。方法收集我院2015年7月至2018年1月60例乳腺非肿块样病变患者的病历资料,均接受MRI检查,检查后行穿刺活检或手术病理检查。以病理组织结果为金标准,计算DCE-MRI、DWI、DWI联合DCE-MRI诊断乳腺非肿块样良、恶性病变的灵敏度、特异度、阳性预测值、阴性预测值、符合率。结果 60例乳腺非肿块样病变中,良性病变38例,恶性病变22例。以流出型为恶性病变的诊断标准,DCE-MRI的灵敏度、特异度、阳性预测值、阴性预测值、总符合率分别为36.4%、86.8%、61.5%、70.2%、68.3%。以ADC值≤1.205×10-3mm2/s为恶性病变诊断标准,DWI的灵敏度、特异度、阳性预测值、阴性预测值、总符合率分别为72.7%、81.6%、69.6%、83.8%、78.3%。DWI联合DCE-MRI的灵敏度、特异度、阳性预测值、阴性预测值、总符合率分别为95.5%、79.0%、72.4%、96.8%、85.0%。DCE-MRI+DWI的灵敏度、阴性预测值、总符合率显著高于DCE-MRI(P<0.05)。结论 DCE-MRI与DWI在乳腺非肿块样病变的良恶性鉴别中均具有一定作用,二者联合可以提高恶性病变的诊断率。     

MRI弥散加权成像在前列腺增生和前列腺癌诊断鉴别中的应用

目的分析MRI弥散加权成像磁共振弥散加权成像(DWI)在前列腺增生和前列腺癌诊断鉴别中的应用。方法将2017年1月~2019年1月在本院经手术或穿刺活检病理确诊的前列腺病变患者病变类型对应前列腺增生组、前列腺癌组;另筛选同期于本院行健康体检的30名志愿者作为对照组。比较三组MRI-DWI参数,并绘制受试者工作特征(ROC)曲线分析MRI-DWI参数对前列腺病变、前列腺癌的诊断鉴别价值。结果与对照组比较,前列腺癌组D、ADC显著较低,f显著较高(P<0.5);与前列腺增生组比较,前列腺癌组D、ADC显著较低,D~*、f显著较高(P<0.05);但前列腺增生组、对照组比较差异无统计学意义(P>0.05);单一MRI-DWI参数诊断前列腺疾病时ADC曲线下面积值(AUC)最高,以1.001×10^-3mm^2/s为cut-off,灵敏度为59.00%、特异度96.70%;联合诊断时特异性上升至100.00%;单一参数诊断前列腺癌时同样以ADCAUC值最高,1.269×10^-3mm^2/s为cut-off,其预测前列腺癌的灵敏度为100.00%、特异度高达86.10%;与联合诊断一致。结论MRI-DWI扫描在前列腺增生及前列腺癌鉴别诊断有较高效能,值得临床推介。     

卵巢癌的磁共振动态增强诊断

目的探讨1.5T磁共振（MRI）动态增强在卵巢癌诊断中的临床应用价值。材料和方法回顾性分析经病理证实的38例卵巢癌动态增强MRI资料,其中27例经手术病理证实,11例经超声引导穿刺活检证实。所有病例均行1.5T磁共振T1加权成像（T1WI）、T2加权成像（T2WI）、扩散加权成像（DWI）及动态增强磁共振成像（DCE MRI）。结果浆液性囊腺癌3例病灶表现为囊性肿块,12例表现为囊实性肿块,3例表现为实性肿块。MRI平扫表现：T1WI呈低信号或稍低、等信号,T2WI呈高、略高信号,信号不均匀,DWI呈不均匀高信号。动态增强扫描表现为厚薄不均的囊壁及实性部分明显强化。粘液性囊腺癌8例病灶为囊实性肿块,6例表现为实性肿块。MRI平扫表现：T1WI、T2WI信号不均匀,呈混杂信号,DWI呈不均匀高信号,病灶内可有出血。动态增强扫描：囊壁、囊内片状阴影、间隔以及结节较明显强化,实性部分强化明显。未分类的囊腺癌3例病灶表现为囊实性肿块,3例表现为实性肿块;平扫及动态增强表现与粘液性囊腺癌相似。结论 1.5T磁共振动态增强对卵巢癌的诊断具有很高的临床应用价值。     

动态增强MRI定量参数对乳腺良恶性肿瘤的鉴别诊断价值

目的探讨动态增强磁共振成像(dynamic contrast-enhanced MRI,DCE-MRI)定量参数对乳腺良恶性肿瘤的鉴别能力。方法搜集经手术病理证实的乳腺肿瘤患者38例,其中良性肿瘤14例,恶性肿瘤24例,术前均行DCE-MRI扫描,选取感兴趣区测量肿瘤的DCE-MRI定量参数K~(trans)(容量转移常数)、K_(ep)(速率常数)、V_e(血管外细胞外间隙容积比)。采用独立样本t检验比较良、恶性肿瘤组间定量参数的差异,绘制ROC曲线分析定量参数对乳腺良、恶性肿瘤的诊断效能。结果乳腺良性肿瘤组K~(trans)、K_(ep)、V_e平均值分别为(0.134±0.121)min~(-1)、(0.273±0.137)min~(-1)、(0.633±0.096);乳腺恶性肿瘤组K~(trans)、K_(ep)、V_e平均值分别为(0.339±0.128)min~(-1)、(0.515±0.169)min~(-1)、(0.680±0.116)。K~(trans)、K_(ep)在良、恶性肿瘤组间差异均有统计学意义(P0.001)。V_e在良、恶性肿瘤组间差异无统计学意义(P0.05)。以最大约登指数确定最佳诊断界值,K~(trans)、K_(ep)的敏感性、特异性和ROC曲线下面积分别为89.17%、93.83%;94.56%、85.71%和0.929、0.902。结论定量参数K~(trans)、K_(ep)可作为乳腺良、恶性肿瘤鉴别诊断的参考指标,且有较高的诊断效能。     

磁共振动态增强扫描对乳腺良恶性病变的诊断价值探讨

目的：探讨磁共振成像动态增强扫描(DCE）在乳腺良恶性病变临床诊断中的应用价值。方法方便收集在该院2010年1月—2014年10月经过手术及病理证实的乳腺病变患者61例,全部病例均行磁共振平扫、DCE扫描。 DCE用Fischer法评分及用BI-RADS法分级后判断良恶性,以病理结果对照,统计平扫加DCE的诊断敏感性、特异性、准确率。结果61例患者中,恶性40例,良性21例,平扫加DCE的诊断敏感性87.5%,特异性85.7%,准确率86.6%。结论磁共振平扫加DCE对乳腺良恶性病变的鉴别诊断有很高的临床价值。     

MRI动态增强扫描与扩散加权成像对乳腺癌诊断价值的对比分析

目的探讨简易乳腺支架配合SPINE matrix线圈MRI动态增强减影扫描及扩散加权成像（DWI）对乳腺癌的诊断价值。方法 37例经手术病理证实的乳腺癌分别采用MRI动态增强扫描、DWI,对比分析其诊断乳腺癌的价值及存在的不足。结果 MRI动态增强减影扫描以形状不规则、毛刺征、环形强化和Ⅱ型或Ⅲ型曲线作为诊断乳腺癌标准,其敏感度分别为78.4%、70.3%、94.6%和89.2%。DWI中b=0时病灶呈明显高信号,随b值增加病灶信号强度依次降低。结论 MRI动态增强扫描对乳腺癌具有特征性的诊断价值;DWI具有重要辅助性的诊断价值。     

1.5T磁共振多b值DWI及ADC值定量分析在前列腺癌与前列腺增生诊断的价值研究

目的探讨1.5T磁共振(MRI)多b值扩散加权成像(DWI)及表观扩散系数(ADC)值定量分析在前列腺癌(PCa)与前列腺增生(BPH)诊断中的价值。方法将我院经病理活检证实为前列腺疾病的232例患者作为研究对象,其中PCa者100例,BPH者132例。所有患者均进行常规1.5TMRI扫描和多b值DWI检查,比较不同b值两组ADC值。结果PCa患者DWI上可见局灶性(或弥漫性)高信号,ADC图显示有对比周围组织较低的低值区;BPH患者DWI显示前列腺增生结节,呈高或稍高信号,ADC图显示有对比周围组织较低的低值区。不同b值下,PCa组ADC值均存在差异,其中b值=1500s/mm^2时的ADC值小于b值=800、1000s/mm^2时的ADC值(P<0.05),b值=1000s/mm^2时的ADC值小于b值=800s/mm^2时的ADC值(P<0.05);b值=800、1000、1500s/mm^2时,PCa组ADC值均低于BPH组(P<0.05)。ROC曲线分析显示当b值=1500s/mm^2时,ADC值诊断效果最佳,所得阈值为1.013×10^-3mm^2/s,敏感度为96.00%,特异度为93.94%。结论1.5TMRI多b值DWI及其ADC值定量分析可有效鉴别PCa和BPH,可在临床推广应用。     

磁共振STIR-EPI序列鉴别良恶性肺结节价值分析

目的探讨磁共振STIR-EPI序列鉴别良恶性肺结节的应用价值。方法选取2012年2月至2013年6月在我院行MRI常规扫描及STIR-EPI弥散加权成像检查的患者125例,所有患者均经病理确诊,其中良性结节43例,恶性结节82例,测定并比较良恶性肺肺结节的信号强度、表观弥散系数（ADC）以及信噪比（SNR）值。结果肺良、恶性肺结节的信号强度分别为（2.22±1.28）和（3.91±1.41）;ADC值分别为（1.979±0.420）×10mm-3/s和（1.384±0.239）×10mm-3/s;SNR值为（195.28±58.34）和（275.02±67.28）。肺良、恶性结节之间信号强度、ADC值及SNR值比较,差异有统计学意义（P〈0.05）。结论磁共振STIR-EPI序列在鉴别肺结节的良恶性中具有重要作用,可作为鉴别肺结节良恶性的重要参考指标。     

脑内原发性淋巴瘤MRI诊断

目的分析脑内原发性淋巴瘤MRI特点．旨在提高对该病的MRI诊断水平。方法分析12洌经手术病理证实的脑内原发性淋巴瘤的MRI表现。结果（1）淋巴瘤呈单发（10例）或多发（2例）,单发者部位包括额叶、颞叶、顶叶、基底节区及中脑;（2）T1WI呈低或稍低信号11例,T2WI呈等信号或硝高信号11例,1例出现坏死及出血;（5）灶周轻度到中度水肿,占位效应亦为轻至中度;（4）增强大多显著均匀强化,呈“握拳”样或团块状．1例环形强化,肿瘤可沿脑脊液播散。结论脑内原发性淋巴瘤的MRI多在大脑深部,明显强化,MRI表现具有一定的特异性,结合MRI影像特点和临床资料综合分析,一般可在术前作出正确诊断。     

MRI中同反相位成相、表观扩散系数以及DWI序列在诊断椎体良恶性疾病中的应用价值

目的探讨MRI中同反相位成相、表观扩散系数以及DWI序列在诊断椎体良恶性疾病中的应用价值。方法分析病理诊断或随访确认为恶性肿瘤椎体压缩骨折患者65例,良性疾病导致的椎体压缩性骨折45例,其中65例恶性患者共计80个椎体,良性疾病共计50个椎体。均行MRI常规序列及DWI扫描并采用双回波技术在3D快速扰相梯度回波序列中采集IP/OP图像;对比良恶性疾病的椎体DWI信号特点测定2组椎体的ADC值、SIR值和SAR值,应用ROC曲线确定最佳诊断指标以及诊断界值。结果良性组与恶性组常规DWI序列信号并无规律可言;良性组ADC值(2.35±0.42)×10-3mm2/s高于恶性组(1.89±0.53)×10-3mm2/s,差异有统计学意义(t=4.859,P0.001);良性组SIR值为(0.65±0.23),恶性组为(1.38±0.21),差异有统计学意义(t=-17.238,P0.001),良性组SAR值为(0.52±0.42),恶性组为(0.19±0.12),差异有统计学意义(t=6.001,P0.001)。SAR值、SIR值以及ADC的ROC曲线下面积分别为65.1%、72.4%和96.5%,ADC的最佳诊断界值为0.837。结论 DWI信号不能用于准确诊断椎体良恶性病变,而ADC值和SIR值、SAR值具有重要的鉴别诊断价值,其中以ADC的诊断价值最高。     

DWI及动态增强MRI鉴别乳腺病变的对比研究简

目的比较磁共振弥散加权成像（DWI）及动态增强MRI（DCE-MRI）对乳腺良恶性病变的诊断价值。方法回顾性分析95例乳腺疾病患者中115个乳腺良恶性病灶,评价DCE-MRI半定量参数信号增强比率（SER）、早期强化率（slope）及ADC值对乳腺良恶性病变的诊断价值。结善乳腺良恶性病变间的SER、slope及ADC值差异均有统计学意义。sER、S1Ope及ADC三者的ROC曲线下面积分别为0．89、0．73、0．91。以最大约登指数为最佳诊断切点值,则三者判断乳腺良恶性病变的敏感性分别为88％、84％、91％;特异性分别为82％、65％、80％。结论DCE-MRI及DWI对乳腺癌均有较高的诊断效能,DWI的诊断效能稍高于定量动态增强MR。     

1H-MR S联合磁共振弥散张量成像诊断HIE患儿的临床效果分析

目的：探讨HIE患儿应用1H-MRS联合DTI诊断临床价值。方法选取本院90例HIE患儿作为本次研究观察组,另选取同期正常分娩的90例健康新生儿为研究对照组。两组均采用1H-MRS及DTI扫描检查,并比较两组影像学图像,测定两组胆碱复合物(Cho)、N-乙酰基天门冬氨酸(NAA)、肌酸复合物(Cr)、乳酸(LAC)、肌醇(MI)、谷氨酸及谷氨酰胺(Glu-Gln)等代谢产物,然后进行比较。结果经检查发现,其中对照组未见DTI异常信号;观察组中,采用DTI检出HIE者为76例,诊断准确率为84.4%明显高于普通MRI检出39例,占43.3%,具有统计学意义,P＜0.05。观察组患儿NAA/Cr明显低于对照组,而Cho/Cr、MI/Cr及Clu+Cln/Cr、Lac/Cr明显高于对照组,差异具有显著性,P＜0.05。结论临床应用DTI可于HIE早期检测中有效显示其病灶范围及数目,同时采用1H-MRS可无创地测量患儿脑部组织缺氧、缺血过程中所产生的代谢产物,两者结合可提高患儿临床诊断准确性,为患者预后评估提供有力价值。