良、恶性软组织肿瘤1H-MRS的临床价值

目的：研究良、恶性软组织肿瘤的氢质子波谱（1H-MRS）特点，探讨1H-MRS用于软组织肿瘤诊断与鉴别诊断的可行性及价值。材料与方法：本组研究共44例，分3组。正常志愿者10例，良性肿瘤组14例，恶性肿瘤组20例。均行常规MRI扫描及1H-MRS检查。观察良、恶性肿瘤组织及正常肌肉1H-MRS表现，在工作站上测量Cho/Cr及Lipid/Cr比值并进行统计学分析。分析30例软组织肿瘤的细胞密度，并与肿瘤组织Cho/Cr值作Pearson相关性分析。结果：恶性肿瘤组织Cho/Cr比值明显高于良性肿瘤及正常肌肉，Lipid/Cr比值低于良性肿瘤及正常肌肉，差异均具有显著性意义（P<0.01）。波谱研究显示，与良性肿瘤组织相比，12例恶性肿瘤组织的Cho、Lac都明显升高，而Lipid、Glc则明显下降。恶性肿瘤平均细胞密度为152/视野，良性肿瘤平均细胞密度为57/视野，两者差异具有显著性意义。软组织肿瘤细胞密度与Cho/Cr值呈明显正相关（r=0.891，P<0.001）。结论：良、恶性软组织肿瘤1H-MRS表现明显不同，1H-MRS对软组织肿瘤的诊断与鉴别诊断具有较高价值。

The value of 1H-MRS in the diagnosis of the soft tissue tumors

Objective：To investigate the proton magnetic resonance spectroscopy（1H-MRS） features of benign and malignant soft tissue tumors in human and to explore its feasibility and application value in the differential diagnosis of soft tissue tumors.Materials and Methods：Forty-four cases were included in the study and divided into three groups.There were 10 cases in nomal group,14 cases in benign tumor group and 20 casese in malignant tumor group.MRI and 1H-MRS were performed in all cases.The 1H-MRS features of all the 44 cases were analyzed.Cho/Cr and Lipid/Cr were calculated on workstation and a statistic test was done.We caculated the cell density of 30 soft tissue tumors and performed pearson correlation analysis between the cell density and Cho/Cr value.Results：The Cho/Cr value in the malignant tumor was larger than that in the benign tumor and normal muscle,but the Lipid/Cr value was smaller than that in the benign tumor and normal muscle.The differences of Cho/Cr value and Lipid/Cr value between malignant and benign soft tissue tumors were statistically significant（P0.01）.In contrast to benign tumor group,1H-MRS revealed increased Cho,Lac and decreased Lipid and Glc peak in the 12 cases of malignant tumor.The average cell density was 152/FOV in the malignant tumor group and 57/FOV in the benign tumor group.The value of the cell density had a significant positive correlation with the Cho/Cr value in soft tissue tumors（r=0.891,P0.001）.Conclusion：The benign and malignant soft tissue tumors in human showed great difference in 1HMRS.1H-MRS has high application value in the differential diagnosis of soft tissue tumors.