脑胶质瘤病的MRI诊断和MRS分析

目的 观察脑胶质瘤病的磁共振表现特点,分析MRS对其诊断、分级、治疗及预后的价值.方法 对12例经手术或活检证实为脑胶质瘤病的患者进行MRI检查,分析病变分布、范围及信号特点;其中5例同时进行MRS检查,包括单体素点解析频谱法以及化学位移成像点解析频谱法,分析代谢物的相对浓度变化.结果 所有患者病变都至少累及2个脑叶,侵及胼胝体9例,基底节区9例,丘脑4例,脑干2例,小脑2例,脊髓1例.病变呈弥漫T1WI低信号、T2WI高信号,信号强度较均匀,少有对比剂增强.5例经MRS检查患者,表现为Cho/Cr,Cho/NAA值的升高,以及不同程度NAA/Cr的降低;3例出现Lactate峰.结论 MRI是脑胶质瘤病的良好检查方法,MRS可提供额外的诊断信息.磁共振成像与MRS结合,有助于诊断治疗,评价手术预后.

MR imaging diagnosis and MR spectroscopy analysis of gliomatosis cerebri

Objective To study the characterization of gliomatosis cerebri (GC) on MR imaging and analyze the value of MR spectroscopy (MRS) in diagnosis, grading, therapy, and prognosis of GC. Methods MR studies of 12 patients with GC were reviewed retrospectively, 5 of which underwent MRS including single-voxel point-resolved spectroscopy and chemical shift imaging. Tumors were confirmed with surgery or biopsy. Distribution, extent and signal features of disease were assessed. MRS result was analyzed. Results Tumors involved at least 2 lobes of the brain in all patients, with extension to the corpus callosum in 9, basal ganglia in 9, thalamus in 4, brain stem in 2, cerebellum in 2 and spinal cord in one patient. Widespread invasion with hyperintensity was noted on T2-weighted MR images. No significant contrast enhancement occurred. Five patients showed elevated Cho/Cr and Cho/NAA levels as well as decreased NAA/Cr ratios, 3 of which showed lactate doublet. Conclusion GC is best detected with MR imaging. MRS is a promising technique for GC. Combining clinical information and MRS findings are very important for making final diagnosis and evaluating prognosis.