增强后多体素^1H-MRS对脑胶质瘤、单发转移瘤和脑脓肿的鉴别诊断价值

目的：探讨注射对比剂后多体素^1H-MRS对脑胶质瘤、单发转移瘤和脑脓肿的鉴别诊断价值。方法：搜集脑胶质瘤16例、单发转移瘤19例和脑脓肿6例，均行注射对比剂后多体素^1H-MRS检查。10例年龄匹配的健康志愿者作对比。比较脑胶质瘤与单发转移瘤强化区及强化边缘区胆碱／肌酸（Cho／Cr）、氮-乙酰天门冬氨酸／胆碱（NAA／Cho）、氮-乙酰天门冬氨酸／对侧相应正常脑组织区胆碱（NAA／Cho-n）和胆碱／对侧相应正常脑组织区胆碱（rCho）值的差异，并做统计学分析。结果：各个级别胶质瘤与单发转移瘤强化区之间Cho／Cr值分别为3．1709±2．197和4．3520±2．509，NAA／Cho-n值分别为0．3312±0．301和0．3843±0．223，差异均无统计学意义（P〉0．05）；而NAA／Cho值分别为0．2436±0．220和0．4550±0．240，rCho值分别为1．5426±0．808和0．9129±0．304，差异均有统计学意义（P〈0．05）；强化边缘区之间上述比值分别为Cho／Cr1．6208±0．230和0．9105±0．414，NAA／Cho-n 0．5357±0．250和0．8015±0．374，NAA／Cho 0．4762±0．278和2．4434±1．636，rCho1．1761±0．423和0．5405±0．497，除NAA／Cho-n外差异均有显著统计学意义（P〈0．001）。脑脓肿出现特征性波谱。结论：增强后多体素^1H-MRS对脑胶质瘤、单发转移瘤和脑脓肿的鉴别诊断有重要的临床应用价值。

Value of post-contrast multivoxel 1 H-MRS in the differential diagnosis of cerebral gliomas, solitary metastase and abscess

Objective：To explore tge value of post contrast multivoxel ^1H-MRS in the differential diagnosis of cerebral glioma, solitary metastases and abscess. Methods： 16 cases of cerebral glioma, 19 cases of solitary metastase, and 6 cases of abscess were collected. All cases were performed post-contrast MR spectroscopy successfully. Ten age-matched healthy volunteers underwent post-contrast ^1H-MR spectroscopy for comparison. The Cho/Cr, NAA/Clio, NAA/Cho-n, rCho value of enhancing region and peritumoral region were compared respectively between glioma and solitary metastases. The results were analyzed statistically. Results： The Clio/Cr of glioma and metastases was 3.1709 ± 2.197 and 4.3520 ± 2.509 respectively; the NAA/Cho-n was 0. 3312 ± 0. 301 and 0. 3843 ±0. 223 respectively. No significant differences were found for all ratios mentioned above between the two groups （ P 〉 0.05）. The NAA/Cho was 0.2436 ± 0.220 and 0. 4550 ± 0. 240 respectively, the rCho was 1. 5426 ± 0. 808 and 0. 9129 ±0. 304 respectively. All ratios had significant differences （ P 〈 0.05 ）. The Cho/Cr in peritumoral regions of the two groups was Cho/Cr 1. 6208 ± 0. 230 and 0.9105± 0.414 respectively,the NAA/Cho-n was 0.5357 ±0.250 and 0.8015 ± 0.374 respectively, the NAA/Cho was 0.4762 ± 0.278 and 2.4434 ± 1.636 respectively,the rCho was 1. 1761 ±0.423 and 0.5405 ± 0.497 respeetively. All ratios had significant differences （ P 〈 0.001） except NAA/Cho-n （ P 〈 0.05）. There was eharaeteristic spectroscopy in cerebral abscess. Conclusion： Post-contrast multivoxel ^1 H-MRS plays an important role in the differential diagnosis of cerebral glioma, solitary metastases and abscess.