质子MR波谱脂质峰升高在颅内疾病鉴别诊断的价值

目的 探讨质子MR波谱(1H-MRS)脂质(Lip)峰升高在颅内疾病诊断和鉴别渗断中的临床应用价值.方法 125例患者,包括脑膜瘤20例、低级胶质瘤19例、高级胶质瘤15例、脑转移瘤21例、淋巴瘤4例、生殖细胞瘤3例、畸胎瘤2例、脑结核瘤26例、腑脓肿15例,在手术或接受其他治疗前行常规MRI及多体素2D 1H-MR...

Elevated Lip signals on 1H-MR spectroscopy in differential diagnosis of intracranial lesions

Objective：To investigate the clinical value of elevated Lip signals on proton MR spectroscopy（^1H-MRS） in the differential diagnosis of intracranial lesions.Materials and Methods：125 patients with intracranial lesions were examined by conventional MR imaging and multivoxel 2D ^1H-MRS before treatments or operations,including meningiomas（n=20）,low-grade gliomas（n=19）,high-grade gliomas（n=15）,metastases（n=21）,lymphomas（n=4）,germinomas（n=3）,teratomas（n=2）,intraaxial tuberculomas（n=26）,and brain abscesses（n=15）.^1H-MRS was performed using PRESS sequence（TR 1000 ms,TE 144 ms）.Concentrations of choline（Cho）,creatine（Cr）,and N-acetylaspartate（NAA） in the lesions were expressed as metabolite ratios.The ratios of Cho/Cr,Cho/NAA and positive ratio of Lip from the solid part of the lesions were calculated and analyzed.Results：There was significant difference on the positive ratios of lipid among the lesions（P〈0.01）.The positive ratios of lipid in lymphomas,germinomas,and teratomas were the highest and those of the low-grade gliomas and meningiomas were the lowest.Significant difference was also found on the ratios of Cho/Cr and Cho/NAA among the benign lesions,low-grade malignancy and high-grade malignancy（Cho/Cr were 1.92±0.75,2.30±0.86,and 3.88±2.08 respectively,P〈0.01;Cho/NAA were 1.80±0.92,2.21±0.14,and 3.75±2.02 respectively,P〈0.05）.The ratios of Cho/Cr and Cho/NAA of high-grade malignancy were the highest and those of benign lesions were the lowest.There was no significant difference on the ratios of Cho/Cr and Cho/NAA between the benign lesions and low-grade malignancy.Conclusion：Elevated Lip signals reveal different pathological characteristics.Lip combined with Cho/Cr,Cho/NAA and conventional MR imaging plays an important role in the differential diagnosis of intracranial lesions.