眼眶肿瘤的氢质子磁共振波谱的临床应用研究

目的:总结眼眶病变MRS特征,研究其生化指标,以及对诊断和鉴别诊断的意义。方法:全部病例共40例,均为单发病灶,行MRI和MRS检查。术后均得到病理证实。其中良性肿瘤和类肿瘤病变30例,恶性肿瘤10例。结果:对照组和肿瘤组比较,不同的眼眶肿瘤,各化合物的变化不同,同对照组比较,眼眶肿瘤NAA均有不同程度下降(P<0.05),海绵状血管瘤下降达52.5%,而小细胞性恶性肿瘤和腺样囊性癌升高明显。良性肿瘤和恶性肿瘤的比较,Cho、Ace和Lac峰有明显差异,恶性肿瘤组明显高于良性肿瘤组。Cr峰相差不明显。Cho/Cr比值有明显增高。结论:肿瘤和正常脑组织的波谱有区别。表现在Lac、Ace的不同变化特征。良性肿瘤和恶性肿瘤的MRS波峰有明显差异,表现为Cho,Cr峰值增高,尤其是Cho/Cr比值的增高,此外Lac和Ace在恶性肿瘤增高明显,提示可作为区别肿瘤与非肿瘤的标志之一。

Clinical Research of Orbital Tumor with 1H MR Spectroscopy

Objective:To study the MR spectroscopy(MRS) findings in orbital diseases,and to investigate the corresponding biochemical parameters and their value for diagnosis,especially for the differential diagnosis of benign and malignant orbital tumors.Methods:40 patients with solitary lesions and all of them underwent MRI and MRS examinations.Pathology diagnosis after surgery was obtained.There were benign tumor and tumor-like lesion(n=30),malignant tumor(n=10).Results:Changes of varied compounds within different orbital tumors were compared with that of normal control group.The NAA peak level within orbital tumors decreased by different degree when compared with the control group(P<0.05),which decreased 52.5% in cavernous hemangioma.However,the NAA level of small cell malignant tumor and adenoid cystic carcinoma increased markedly.There were marked differences in of Cho,Ace and Lac levels between benign and malignant tumors,which were much higher in malignant tumors.The value of Cho/Cr was much higher in malignant tumors,yet the Cr peak value did not show obvious difference.Conclusion:The MRS of tumors was different from that of normal brain tissue,manifested as various characteristic changes on Lac and Ace.The MRS peak values were different between benign and malignant tumors,such as the increased peak value of Cho and Cr,especially the increase of Cho/Cr value.Additionally,the Lac and Ace values were much higher in malignant tumors,which might become one of the criteria for the differential diagnosis of neoplasm and other diseases.