磁共振波谱技术在乳腺癌诊断中的应用

目的:利用氢质子磁共振波谱(1H MRS)技术检测活体乳腺癌病灶与对侧正常乳腺组织内的物质代谢和物质生化含量的差异及其反映在分子水平上的病理改变。方法:对30例经乳腺钼靶摄影疑为一侧乳腺癌的患者行1H MRS检查,比较其病侧与对侧相应部位正常腺体组织的胆碱(Choline,Cho)、乳酸(Lactine,Lac)含量有无显著性差异。结果:正常乳腺组织1H MRS在1.32ppm处显示一独立清晰的乳酸峰,胆碱峰显示低平,Cho峰顶与Lac峰顶的连线呈上升趋势。30例病侧组在3.2ppm处Cho峰显著增高,Lac峰明显降低,Cho峰顶与Lac峰顶的连线呈下降趋势;两组间行秩和检验,差异有显著性(P<0.05)。结论:氢质子磁共振波谱(1H MRS)对于乳腺癌的定性诊断可提供有价值的辅助信息。     

正常和骨质疏松腰椎3．0T磁共振波谱和扩散张量成像

目的：检测3．0T磁共振波谱和功能成像在评价不同骨密度女性椎体塌陷的风险和早期诊断以及测量椎体骨髓脂肪含量的可行性和可重复性。方法：2005年1月～10月对50例年龄32～72岁的女性进行前瞻性研究。每位受检者行腰椎双能X线吸收计量法和3．0T磁共振^1H波谱和扩散张量成像，     

磁共振波谱技术在乳腺癌诊断中的应用

乳腺癌是临床常见的恶性肿瘤之一,MR在乳腺癌的诊断中发挥着重要的作用。磁共振波谱技术是能检测体内生化代谢的微创性检查方法,本文介绍磁共振波谱在乳腺癌诊断和评价治疗效果中的应用现状。     

脑质子磁共振波谱在早期帕金森病诊断中的价值

目的　探讨质子磁共振波谱 ( 1H -MRS)在早期帕金森病 (Parkinson’sdisease ,PD)诊断中的临床应用价值。方法　对 10例偏侧PD患者 (Hoehn -YahrⅠ级 )和 10例年龄匹配正常对照者双侧基底节区进行 1H -MRS检测 ,对比分析PD患者患侧肢体对侧和同侧以及正常对照者的基底节区N -乙酰基天门冬氨酸 (NAA) /肌酸复合物 (Cr)和胆碱复合物 (Cho) /Cr比值的变化。结果　PD组患者患侧肢体对侧的基底节区NAA/Cr比值显著低于同侧和正常对照组 (P <0 .0 5 ) ,Cho/Cr比值显著高于同侧和正常对照组 (P<0 .0 5 ) ;PD组患者患侧肢体同侧的基底节区NAA/Cr和Cho/Cr比值与正常对照组比较无显著差异 (P >0 .0 5 )。结论　1H -MRS是可以为具有单侧症状的PD患者基底节区的神经细胞病理学改变提供有价值的信息的一种无创技术     

原发性中枢神经系统B细胞淋巴瘤的磁共振波谱和病理对照

目的:阐明原发性中枢神经系统B细胞淋巴瘤(PCNSL)的氢质子磁共振波谱表现,并与病理进行对照。材料和方法:10例病理证实的PCNSL行磁共振常规及二维多体素波谱俭查,分析肿瘤实质、瘤周区域以及对侧的谱线,并将肿瘤实质的波谱与病理对照。结果:PCNSL的波谱表现为Cho峰升高及NAA、Cr峰的降低,1.3ppm处升高的Lip峰。瘤体和瘤周区域在Cho/Cr、Ch/NAA上有显著差异;Cho/Cr在瘤周区域2、3之间存在显著性差异,在瘤周区域2和对侧之间存在差异而在瘤周区域3和对侧之间无差异;1例病灶在瘤周区域3以远处仍可见异常谱线。HE染色和KP-1染色显示:HE染色显示肿瘤细胞密集,细胞形态较为单一;KP-1染色显示含脂质组织细胞散在分布于肿瘤细胞间。结论:PCNSL对周围浸润达到肿瘤强化边缘外15mm处,这可能对淋巴瘤的治疗有意义,而Lip峰和脂质吞噬细胞有关。     

体外线圈磁共振波谱分析在前列腺病变诊断中的价值

目的:探讨采用体外线圈进行三维磁共振波谱分析(three dimensional magnetic resonance spectroscopy,3DMRS)检查在前列腺病变诊断中的价值。方法:分析19例前列腺癌、26例前列腺增生患者的3D MRS资料,采用One-way ANOVA检验对前列腺癌、前列腺增生及正常前列腺外周叶Cho+Cr/Cit(CC/C)平均比值进行统计学分析,比较是否具有统计学差异性。结果:前列腺癌、前列腺增生及正常前列腺外周叶CC/C平均比值分别为2.58±1.61,0.57±0.25,0.36±0.18。前列腺癌与前列腺增生、正常前列腺外周叶组间的差异有显著统计学意义(F=211.338,P<0.01)。结论:体外线圈进行前列腺3D MRS能够较好的检出前列腺病变中的代谢物,并有助于前列腺疾病的诊断及鉴别诊断。     

磁共振波谱在小儿癫痫中的应用

癫痫在小儿发病率最高,ＭＲＩ及ＭＲＳ对于其病因诊断及指导治疗起重要作用。本文总结了小儿癫痫的ＭＲＩ表现及病理基础,同时指出其与成人癫痫磁共振研究方面的差距;详细阐述了ＭＲＳ技术并分别对＾１Ｈ ＭＲＳ和＾３１Ｐ ＭＲＳ在小儿发育过程中各代谢成份的变化趋势加以总结;分析了小儿癫痫中各代谢成份在癫痫中所起的作用,指出ＭＲＩ与ＭＲＳ联合应用对小儿癫痫病因学的诊断将大有裨益。     

磁共振波谱对胰腺癌的诊断价值

_目的：探讨磁共振波谱（MRS）对胰腺癌的诊断价值。方法：应用单体素点分辨波谱（PRESS）序列,采集53例非胰腺癌受检者（包括26例正常胰腺,16例急性胰腺炎,11例慢性胰腺炎）及22例胰腺癌患者的胰腺质子磁共振波谱（1 H-MRS）图像。通过分析非癌组与癌组胰腺波谱中代谢物的表现,比较两组的代谢物峰显示率,计算每组胰腺波谱中胆固醇和不饱和脂肪酸的混合峰（Chol＋Unsat）与脂肪峰（Lip）峰高的比值（Chol＋Unsat/Lip）,在胰腺癌与非胰腺癌的比值之间进行受试者工作特征（ROC）曲线分析。结果：胰腺1 H-MRS 显示的主要代谢物峰有 Lip 峰、Chol＋Unsat 峰和胆碱（Cho）峰。胰腺癌组与非胰腺癌组的 Chol＋Unsat/Lip 比值分别为0．181±0．059和0．328±0．111,两组比值差异有统计学意义（r＝2．913,P＝0．008）。经计算得出 ROC 曲线下面积为0．857（P＝0．000）。当 Chol＋Unsat/Lip 比值临界值取0．286时,1 H-MRS 鉴别诊断胰腺癌与非胰腺癌的敏感度为68．2％,特异度为100％。结论：胰腺1 H-MRS 中 Chol＋Un-sat/Lip 比值升高对诊断胰腺癌有一定价值。     

磁共振波谱及其在脑疾病中的临床应用价值

磁共振波谱即MRS是一种无创性的检测脑内各种代谢物变化的方法,飞速发展的临床磁共振技术使得波谱质量和空间分辨率明显提高,MRS已经成为一种评价中枢神经系统各种疾病的诊断工具,其中包括癫痫、脑肿瘤、脑缺血及退行性疾病等,本文主要阐述了MRS的基本原理、检查方法以及其在神经系统疾病中的临床应用。     

质子磁共振波谱对脑肿瘤的鉴别诊断价值

目的初步探讨氢质子磁共振波谱(1H-MRS)对不同脑肿瘤的诊断及鉴别诊断价值.材料和方法39例颅内肿瘤分别行常规MRI及1H-MRS检查,将肿瘤实质与对侧相应部位及正常对照组行对照研究.检查方法为PRESS序列,主要观察代谢物为氮-乙酰天门冬氨酸(NAA)、含胆碱的化合物(Cho)、肌酸(Cr/PCr)、乳酸(Lac)和脂类(Lipids).结果几乎所有肿瘤波谱均呈现NAA峰降低,Cho升高,Cho/Cr及Cho/NAA比值升高,与正常组织相比有显著性差异(p＜0.05).低度恶性胶质瘤组8例Cho/Cr、NAA/Cr、NAA/Cho代谢物比值分别为1.87±0.45、1.13±0.26、0.74±0.21;高度恶性胶质瘤组7例的代谢物比值的均值分别为2.75±1.17、1.07±0.31和0.62±0.28;脑膜瘤组11例,其代谢物比值的均值分别为6.04±2.15、0和0;转移瘤组10例,其代谢物比值的均值分别为2.32±1.08、1.22±0.17和1.23±0.46.胶质瘤组2例术后与术前比较Cho/Cr比值有明显降低.淋巴瘤1例放疗后较放疗前Cho/Cr比值降低;听神经鞘瘤1例见升高的Cho峰;蛛网膜囊肿1例仅见Lac峰.结论H1-MRS对脑肿瘤的诊断及鉴别诊断、治疗后随访、手术后疗效的评价均有重要价值,可作为一种非损伤性的辅助诊断手段.     

氢质子MR波谱评估骨质疏松的初步研究

目的探讨椎体氢质子MR波谱（^1H MRS）测量值与双能X线（DXA）及定量CT（QCT）所测骨密度（BMD）值的相关性。方法152名[30-80岁，平均（58±14）岁]女性志愿者分别进行以下检查：胸腰椎侧位（T4-L4）X线平片，并采用Genant半定量法对其进行评阅。腰椎（L2-4）用DXA及QCT进行BMD测量。腰椎常规行矢状面T2WI、T1WI和横轴面T2WI。MR常规扫描结束后采用单体素点解析波谱（PRESS）序列对L2-4椎体进行波谱采集，相应谱线采用SAGE 7．0软件分析，并计算脂水比（LWR）、脂肪比（FF％）及水峰、脂峰线宽（LW）等相关椎体MRS定量指标。结果FF％、LWR随年龄增加逐步增大；平均LWR（2．71）与DXA、QCT所测平均BMD值（分别为1．038g／cm^2和104．2mg／cm^3）具有相关性（r值分别为-0．477、-0．769，P值均〈0．01）。水峰LW随年龄增加呈逐渐变窄趋势，其同DXA、QCT测量的BMD具有相关性（r值分别为0．439、0．712，P值均〈0．01）。脂峰线宽无明显变化趋势，且同DXA、QCT所测BMD无明显相关性（r值分别为-0．183、-0．199，P值均〉0．05）。结论MRS可在常规腰椎MR基础上无创性评估椎体骨髓状况，进而来评估骨髓的变化对于骨量所带来的影响。     

Quantification of vertebral bone marrow fat content using 3 Tesla MR spectroscopy: reproducibility, vertebral variation, and applications in osteoporosis

Purpose:

To determine the reproducibility of proton MR spectroscopy (¹H‐MRS) for assessing vertebral bone marrow adiposity at 3 Tesla (T); to evaluate variation of marrow adiposity at different vertebral levels; and to demonstrate the feasibility of using ¹H‐MRS at 3T for evaluating marrow adiposity in subjects with low bone density.

Materials and Methods:

Single voxel MRS was acquired at vertebral body L1 to L4 at 3T in 51 postmenopausal females including healthy controls (n = 13) and patients with osteoporosis/osteopenia (n = 38). Marrow fat contents were compared between vertebral levels and between groups using analysis of variance (ANOVA). Six subjects were scanned twice to evaluate technique reproducibility.

Results:

The average coefficient of variation of vertebral marrow fat content quantification was 1.7%. Marrow fat content significantly increased from L1 to L4. The average fat content was significantly elevated in patients with osteoporosis/osteopenia compared with controls, adjusted for age and body mass index (P < 0.05).

Conclusion:

In vivo MRS at high field strength provides reliable measurement of marrow adiposity with excellent reproducibility and can be a valuable tool for providing complementary information on bone quality and potentially also fracture risk. J. Magn. Reson. Imaging 2011;33:974–979. © 2011 Wiley‐Liss, Inc.     

脊柱良恶性压缩骨折的MR波谱分析

目的探讨骨质疏松和恶性肿瘤所致脊柱良恶性压缩骨折的MR氢质子波谱(1HMRS)特征。方法对37例骨质疏松和21例恶性肿瘤所致椎体压缩性骨折病例进行1H MRS采集,同时以30例健康志愿者L2椎体的1H MRS作对照,定量分析感兴趣椎体的脂肪百分含量(FF%)及脂与水的比率(LWR)。结果对照组L2椎体平均脂肪含量为(45.0±20.2)%,平均LWR为0.76;骨质疏松组病变椎体的平均脂肪含量(67.0±14.3)%,平均LWR为1.75;恶性肿瘤组病变椎体平均脂肪含量(1.8±1.2)%;平均LWR为0.1。骨质疏松组FF%和LWR明显高于恶性肿瘤组(t=2.87,P<0.01),亦较高于正常对照组(t=2.06,P<0.05);恶性肿瘤组FF%和LWR明显低于正常对照组(t=2.75,P<0.01)。结论1H MRS能无创性检测脊柱椎体的脂肪含量及LWR,脊柱良恶性压缩椎体的脂肪含量及LWR差异有统计学意义,有助于骨质疏松和恶性肿瘤所致椎体压缩性骨折的鉴别诊断。     

Determination of bone mineral density in the third lumbar vertebral body using photon absorptiometry techniques

Dual-photon absorptiometry and triple-energy X-ray absorptiometry were used to investigate the total bone mineral content and density as well as the trabecular bone mineral density in the third lumbar vertebral body. Both anteroposterior (AP) and lateral (LAT) measurements were performed. By combining the two projections it was found that the mean trabecular bone mineral density for all 202 subjects included in the study was 52% (SD±20%) of the total bone mineral density in the third lumbar vertebral body. The mean trabecular bone mineral density as a fraction of the total vertebral body bone mineral density decreased as a function of age. The relative annual change in this fraction differed between males and females. It was also found that neither trabecular nor total bone mineral density differed significantly between male and female subjects aged 25–35 years, and bone mineral density (BMD), expressed in g/cm³, showed no correlation to subject height, body weight or body mass index (BMI). Male and female individuals showed different rates of change of trabecular bone mineral density with age.     

Gadolinium enhancement of vertebral endplates following lumbar disc surgery

Gadolinium enhancement may be normal in the vertebral endplates adjacent to previously operated intervertebral discs. To determine the frequency of this finding and to differentiate this normal healing process from early lesions due to focal infection, we studied 135 patients who had undergone surgery for herniated lumbar disc, and compared them with 249 unoperated patients with radicular symptoms and 15 with known spondylodiscitis. Hypointense foci which enhanced with gadolinium were identified in the endplates of 25 (18.5%) of the operated patients, 9 of whom required a second operation for recurrent disc herniation, at which time the absence of infection was confirmed. Gadolinium enhancement within the endplates adjacent to the operated disc occurs during normal healing after surgery. Care should be taken before invoking a diagnosis of focal infection or secondary spondylodiscitis.     

MRS骨髓脂肪含量预测骨质疏松性髋部骨折的价值

目的 探讨股骨颈骨髓脂肪含量(BMF)对评估骨质疏松(OP)髋部脆性骨折风险的预测价值.方法 15例女性髋部骨折组(年龄68.3岁±9.4岁)及74例女性非骨折正常对照组(年龄61.6岁±10.3岁)行髋部双能X线吸收测量法扫描获取股骨颈骨密度(FN-BMD)及磁共振波谱(MRS)扫描测定BMF.采用受试者工作特征曲线(ROC)分析FN-BMD及BMF对预测髋部骨折风险的差异.结果 BMF与FN-BMD(r=-0.579)、年龄(r=0.460)、体重(r=-0.270)、体质量指数(BMI)(r=-0.239)存在轻-中度相关性(P均＜0.05),将年龄、体重、BMI作为协变量加以校正,BMF与FN-BMD之间的相关性依然存在(r=-0.374,P＜0.001).校正年龄、体重、BMI后,髋部骨折组FN-BMD较非骨折组低(P=0.020),BMF较非骨折组高(P=0.007).即使将FN-BMD加以校正,BMF在2组间差异仍存在统计学意义.FN-BMD及BMF判定髋部骨折的ROC曲线下面积分别为0.810、0.801,两者对骨折风险评估无统计学差异(P=0.894 5). BMF联合FN-BMD判定髋部骨折的R)C曲线下面积为0.826,与单独FN-BMD预测髋部骨折风险的能力无统计学意义(P=0.650 2).结论 股骨颈BMF是独立于FN-BMD决定髋部骨强度的预测因子,但BMF联合FN-BMD并不能提高对髋部脆性骨折的预测能力.     

Relationship between hip bone mineral density and lumbar disc degeneration: a study in elderly subjects using an eight-level MRI-based disc degeneration grading system

Purpose:

To study the relationship between hip bone mineral density (BMD), lumbar disc degeneration, and lumbar disc space narrowing in elderly subjects.

Materials and Methods:

The study cohort comprised 196 females and 163 males (age range, 67–89 years) with no age difference between the two groups. Anteroposterior total hip areal BMD was measured with DXA and lumbar spine MRI was acquired using a 1.5 Tesla scanner. Lumbar disc degeneration was assessed using an eight‐level grading system wherein each grade represents a stepwise progression from normal disc to severe disc degeneration and disc space narrowing.

Results:

After controlling for the age effect, no significant relationship was observed between total hip T‐score status and severity of disc degeneration. There was no significant difference in total hip BMD in the subjects with or without the disc space narrowing (P < 0.05). Female subjects are more likely to have a narrowed disc space than males at all levels, and being statistically significant at L3/4 and L4/5 levels, and with an overall significance of P = 0.007.

Conclusion:

There was no association observed between hip BMD and lumbar disc degeneration. Elderly females were more likely to have a narrowed lumbar disc space than elderly males. J. Magn. Reson. Imaging 2011;33:916–920. © 2011 Wiley‐Liss, Inc.     

磁共振脂肪抑制技术在老年人腰椎病变中的应用研究

目的：探讨磁共振脂肪抑制技术在老年人腰椎病变中的临床应用研究。方法：2012-05~2013-05对120例年龄60~80岁老年人腰椎退行性改变患者行磁共振检查（MRI）,磁共振检查序列包括快速自旋回波脉冲序列（FSE）T2WI、自旋回波脉冲序列（SE）T1WI、脂肪抑制序列等。回顾性分析腰椎退行性改变的MRI表现。结果：MRI检查在常规SE序列中显示病灶110例（91.6%）,FSE序列中显示病灶116例（96.6%）,脂肪抑制序列中显示病灶120例（100%）,病变在脂肪抑制序列里显示最明显。结论：脂肪抑制技术在老年人腰椎病变中能清楚显示磁共振常规扫描中发现不了的病变,尤其在老年人有相关临床症状时脂肪抑制技术非常必要,为影像科诊断医生出具正确诊断提供技术支持,建议在老年人腰椎磁共振扫描中常规加扫脂肪抑制序列。     

脊柱原发性骨质疏松椎体压缩的MRI表现

目的探讨脊柱原发性骨质疏松椎体压缩的ＭＲＩ表现。方法对３年间Ｘ线诊断、临床证实的６０例脊柱原发性骨质疏松的ＭＲＩ表现进行回顾分析，并与对照组比较。结果１６２个椎体表现为压缩变形，其中凹陷形９８个，楔形５１个，扁平形１３个。压缩椎体邻近椎间盘常膨突到椎体凹陷区内；矢状位Ｔ１ＷＩ４７个椎体表现为椎体内不同范围、不同类型的低信号。结论压缩椎体后上角突入椎管内，Ｔ１ＷＩ椎体终板下呈带状低信号和除椎体后角外全椎体呈低信号，为原发性骨质疏松椎体压缩ＭＲＩ比较典型的表现。     

脑白质疏松症的MR扩散加权成像及波谱研究

目的通过MR扩散加权成像(DWI)及MR波谱(MRS)分析脑白质疏松症(LA)的表观扩散值(ADC)和不同代谢产物比值的变化,探讨LA中脑白质缺血过程中出现的病理、生化改变与MR功能成像改变之间的关系。方法30例经常规MRI检查诊断为LA患者,及30例年龄相匹配的正常脑白质表现的患者作为对照组,进行DWI检查,分析病变不同区域ADC值的变化,同时对LA患者进行MRS分析N-乙酰天门冬氨酸(NAA)/肌酸(Cr)、胆碱复合物(Cho)/肌酸(Cr)比值的变化,比较不同位置和不同程度病变在ADC值和代谢变化中的差异。结果LA患者病灶区(双侧侧脑室枕角、体部旁脑白质)ADC值升高与对照组差异有显著的统计学意义(P<0.01),相应病灶区的NAA/Cr均值明显降低,Cho/Cr均值升高,与正常白质比较差异有显著统计学意义(P<0.01),而枕角的NAA/Cr均值低于体部,差异有显著统计学意义(P<0.01)。结论磁共振功能成像能够反映脑白质疏松症发展中的微观结构变化和局部代谢的异常。