软组织肿瘤良恶性鉴别的术后标本1H-MRS研究

目的：探讨术后标本1H-MRS鉴别软组织肿瘤良恶性的意义。方法：29例软组织肿瘤术后新鲜标本行常规MRI及1H-MRS测量,比较良、恶性肢体软组织肿瘤在1H-MRS代谢物胆碱（Cho）、肌酸（Cr）、三甲胺（TMA）、N-乙酰天门冬胺酸（NAA）、细胞内脂质IMCL（Lip1）、细胞外脂质EMCL（Lip2）相对浓度（即代谢物峰下平均面积）及Cho/Cr、TMA/Cr、NAA/Cr、Lip1/Cr、Lip2/Cr相对浓度比值,进行差异的t检验。结果：良性软组织肿瘤共11例,各代谢物相对浓度比值之均值分别为TMA/Cr1.02±0.50,Cho/Cr0.98±0.60,NAA/Cr0.46±0.34,Lip1/Cr7.88±6.23,Lip2/Cr5.72±4.46。恶性软组织肿瘤共18例,各代谢物相对浓度比值之均值分别为TMA/Cr2.47±1.04,Cho/Cr2.02±0.72,NAA/Cr0.41±0.39,Lip1/Cr1.41±1.31、Lip2/Cr1.01±0.93。本组资料用于诊断的恶性软组织肿瘤的TMA/Cr、Cho/Cr的阈值分别为1.19和1.21,其准确度分别为96.3%和88.9%,其诊断准确性均位于较高水平。用于诊断的良性软组织肿瘤的Lip1/Cr、Lip2/Cr的阈值分别为2.03和0.82,其准确度分别为90%及80%,其诊断准确性分别位于较高及中等水平。用于诊断的良性软组织肿瘤的NAA/Cr的阈值为0.035,其准确度分别为57%,其诊断价值位于较低水平。结论：Cho/Cr、TMA/Cr、Lip1/Cr、Lip2/Cr比值可作为软组织肿瘤良、恶性程度鉴别诊断的依据。

Differentiation of benign and malignant soft tissue tumors by ~1H-MR spectroscopy:based on surgical specimens

Objective:To explore the value of 1H-MRS in differentiating benign and malignant soft tissue tumors.Methods:Twenty-nine surgical specimens of the limbs and trunk were collected after operations and 1H-MRS was immediately done with surface coil.Metabolites including Choline (Cho),Creatine (Cr),Trimethylamine (TMA),NAA (N-acetyl-acetate) and Cho/Cr,TMA/Cr,NAA/Cr,Lip1/Cr,Lip2/Cr were measured in the specimens,of which 11 were benign and 18 malignant pathologically.Results:The ratios of TMA/Cr,Cho/Cr,NAA/Cr,Lip...