1H-MRS在脑胶质瘤肿瘤周围组织的临床应用研究

目的分析脑胶质瘤肿瘤周围组织的1H-MRS表现,探讨脑胶质瘤肿瘤周围组织的1H-MRS特点与肿瘤侵袭性的相关性。方法收集经临床手术、病理证实的脑胶质瘤36例,按照MRI检查结果分成两组:肿瘤周围区域有水肿组、肿瘤周围区域无水肿组。所有患者在术前行1H-MRS检查,均在MR非增强成像的基础上获得。使用1.5T超导磁共振、多体素扫描、点分辨表面线圈法,检测不同区域代谢物变化。结果脑胶质瘤肿瘤周围组织的1H-MRS表现:Cr轻度下降,NAA下降,Cho增高。肿瘤周围水肿组织和肿瘤组织、对侧正常脑组织的NAA/Cr、Cho/Cr、NAA/Cho比值存在显著性差异(P<0.05)。脑胶质瘤肿瘤周围无水肿组织和肿瘤组织的NAA/Cr、Cho/Cr、NAA/Cho比值存在显著性差异(P<0.05);肿瘤周围无水肿组织和对侧正常脑组织的NAA/Cr、NAA/Cho比值存在显著性差异(P<0.05),但Cho/Cr比值无显著性差异(P>0.05)。20例肿瘤周围水肿组与16例肿瘤周围无水肿组的肿瘤组织、肿瘤周围组织的NAA/Cho比值均存在显著性差异(P<0.05),但NAA/Cr、Cho/Cr比值无显著性差异(P>0.05)。结论1H-MRS可评价肿瘤周围组织(水肿区或无水肿区)肿瘤细胞浸润情况,反映肿瘤生长潜能,为制定治疗方案提供帮助。

Clinical application of 1H-MRS in peritumoral area of brain gliomas

Objective To evaluate the proton magnetic resonance spectroscopy((~1H)-MRS) findings of brain glioma,and to explore the correlation between()~1H-MRS findings and the invasion ability of tumors.Methods Thirty-six cases with glioma were studied.The diagnosis were pathologically confirmed after surgery.According to MRI manifestations,all cases were categorized into two groups(peritumoral edema and nonedema of gliomas).All of them underwent()~1H-MRS examinations before surgery,which were performed before contrast enhancing examinations.Multiple voxel 1H-MRS was performed on a 1.5 T MR scanner using pointed-resolved spectroscopy(PRESS).The variety of metabolite peaks were detected in different areas.Results Slightly decreased Cr,decreased NAA and increased Cho were found in peritumoral area of brain gliomas.Significant differences were found in the ratios of NAA/Cr,Cho/Cr and NAA/Cho(P<0.05) between peritumoral edema regions and normal tissue in contralateral hemispheres and between peritumoral nonedema regions and spectra of tumors.Significant differences were found in the ratios of NAA/Cr and NAA/Cho(P<0.05) between peritumoral nonedema regions and normal tissue in contralateral hemispheres,but not in the ratios of Cho/Cr(P>0.05).Significant differences were found in the ratios of NAA/Cho(P<0.05) in spectra of tumors,peritumoral regions between the peritumoral edema and nonedema groups,but not in the ratios of NAA/Cr and Cho/Cr(P>0.05).Conclusion()~1H-MRS has made it possible to estimate peritumoral edema or nonedema of gliomas implicated by tumor and to reflect their develop potential.