PWI联合MRS在鞍旁海绵状血管瘤与脑膜瘤鉴别诊断中的价值

目的探讨灌注加权成像(perfusion weighted imaging,PWI)、磁共振波谱成像(magnetic resonance spectroscopy,MRS)对鞍旁海绵状血管瘤和鞍旁脑膜瘤的鉴别诊断价值。方法回顾性分析经证实的6例鞍旁海绵状血管瘤和10例鞍旁脑膜瘤患者磁共振常规扫描、MRS、PWI及增强扫描影像资料,测量肿瘤内最大局部血容量(region cerebral blood volume,rCBV)值与正常白质区局部血容量值并求两者的比值(nCBV),对两组间nCBV值进行统计学分析。结果常规和增强扫描在二者鉴别上困难,但鞍旁脑膜瘤组nCBV(6.119±2.564)值明显高于鞍旁海绵状血管瘤组nCBV(1.367±1.132),差异有显著性;鞍旁海绵状血管瘤波谱特点为无N-乙酰天门冬氨酸、胆碱和肌酸等峰,只见明显脂质峰;鞍旁脑膜瘤无N-乙酰天门冬氨酸、肌酸等峰,均见明显胆碱峰,3例可见丙氨酸峰,两者MRS表现具有明显差异性。结论 PWI联合MRS在鞍旁海绵状血管瘤与鞍旁脑膜瘤的鉴别诊断中具有较高的价值。

Differential Diagnosis of PWI Combined with MRS Beside the Saddle Cavernous Hemangioma with Meningioma

Objective To evaluate the perfusion weighted imaging (PWI) and magnetic resonance spectroscopy (MRS) cavernous hemangioma around the saddle and saddle beside the differential diagnosis of meningioma.Methods A retrospective analysis of six confirmed cases in the cavernous hemangioma and 10 cases in the patients with meningiomas mri routine scan, MRS, PWI and enhanced scan image data, measurement of tumour biggest region blood volume (rCBV) value and normal white matter area of region blood volume and ratio of the two (nCBV), statistical analysis was carried out on the nCBV values between the two groups.Results The results of conventional and enhanced scan in both difficult to identify, but the nCBV value of the meningioma near the saddle (6.119±2.564) was significantly higher than those in the cavernous hemangioma group (1.367±1.132). In the cavernous hemangioma spectrum characteristics to N-acetyl aspartate , choline and creatine peak, see clear lipid peak. Next to the saddle meningioma no N-acetyl aspartate, creatine, such as peak, 3 cases of visible peak alanine, see clear choline peak, both MRS has obvious differences in performance.Conclusion MRS joint PWI beside the saddle in the cavernous hemangioma and has high value in the differential diagnosis of meningioma.