脑胶质瘤和脑膜瘤的二维多体素氢质子磁共振波谱

目的　比较脑胶质瘤和脑膜瘤代谢产物的氢质子波谱变化规律。方法　对经手术和病理证实的 17例脑胶质瘤和 15例脑膜瘤患者行磁共振头颅平扫、增强和二维多体素氢质子磁共振波谱 ( 1H MRS)检查 ;采用分析软件包FuncTool在代谢与解剖叠加图像上选择感兴趣区 (ROI) ,取 4个个体体素 ,移动像素至肿瘤实体区、肿瘤周边区及对侧正常区 ,在波谱图上观察波谱变化情况 ;经统计学处理 ,分别计算出肿瘤实体区、瘤周区和对侧正常区的NAA/Cho、NAA/Cr及Cho/Cr比值。结果　 17例脑胶质瘤中瘤体区胆碱 (Cho)明显升高者 15例 ,N 乙酰天门冬氨酸 (NAA)均有不同程度下降。瘤体区NAA/Cho、NAA/Cr和Cho/Cr比值与正常对照区均存在显著差异 (P <0 .0 1) ,与瘤周区对比有较显著性差异 (P <0 .0 5 )。15例脑膜瘤中瘤体区Cho明显升高 ,NAA峰消失或不明显 ,瘤周区Cho升高不明显 ,NAA峰基本正常。瘤体区NAA/Cho、NAA/Cr和Cho/Cr比值与正常对照区均具显著差异 (P <0 .0 5 ) ,而瘤周区无显著性差异 (P >0 .0 5 )。脑胶质瘤与脑膜瘤的瘤体区的NAA/Cho、NAA/Cr、Cho/Cr比值之间具有显著性差异 (P <0 .0 5 )。结论　多体素二维氢质子磁共振波谱对于鉴别脑胶质瘤和脑膜瘤以及了解肿瘤浸润范围可提供有价值的信息。

Comparative Study of Metabolism of Brain Glioma and Meningioma with Two-Dimensional

Objective To compare the changes of 1H-MRS of metabolism of brain glioma and meningioma.Methods MR imaging were performed in 17 cases of glioma and 15 cases of meningioma proved surgically and pathologically.The sequences included plain scan,contrast-enhanced scan and 2D multivoxel 1H-MRS.The region of interest on metabolic-anatomic images were selected into 4 pixels with software FuncTool.Each pixel was separately located at tumor area,the surrounding area of tumor and normal control area.According to spectra of these areas,N-acetylaspartate/Choline (NAA/Cho),NAA/creatine(Cr) and Cho/Cr ratios were calculated.Results All patiens with glioma showed varying degree decreased NAA value and 15 out of 17 cases of glioma shaved obviously elevated Cho value.NAA/Cho,NAA/Cr and Cho/Cr ratios were significantly different between tumor and control area(P<0.01).There was significant difference between tumor and the surrounding of glioma (P<0.05).Cho value of all patiens with meniginoma was elevated in tumor area and NAA peak disappeared.Cho value in the surrounding area was not increased obviously,and NAA value was normal.NAA/Cho,NAA/Cr and Cho/Cr ratios were significantly different between tumor area of meniginoma and normal control area (P<0.05).There was no significant difference between tumor area and the surrounding of meniginoma (P>0.05).Significant difference between glioma group and meniginoma group was found in NAA/Cho,NAA/Cr and Cho/Cr ratios(P<0.05).Conclusion Two-dimensional multivoxel proton magnetic resonance spectroscopy ( 1H-MRS) may provide valuable information for distinguishing glioma from meniginoma and understanding the region infiltrated by tumor.