多体素质子MRS对脑肿瘤放射性脑损伤及复发诊断的临床应用

目的探讨氢质子磁共振波普（1H—MRS）在脑肿瘤放射治疗过程中，对放射性脑损伤和脑肿瘤复发的评估及两者鉴别诊断中的临床意义。方法选择22例经普通放疗后、在常规MRI图像上发现原肿瘤部位周边照射野内或照射的高剂量区内有新的异常强化灶的脑星形细胞和脑转移瘤患者，其中，男性14例，女性8例，年龄20—66岁，平均年龄42．9岁；星形细胞肿瘤16例、脑转移瘤6例。使用美国GE公司Signacv／I 1．5T超导型MR装置，MRS数据的搜集应用配置屏蔽梯度和鸟笼形头部线圈的1．5T超导型磁共振仪（signa；GEMedicalSystems；Milwaukee），多体素1H—MRS采用PRKSS序列。结果放射性脑损伤的氮一乙酰门冬氨酸（NAA）、胆碱（Cho）及肌酐（cr）下降或消失，NAA／Cr比值与Cho／Cr比值均下降，脑肿瘤复发Cho上升，NAA明显下降。Cho／Cr、Cho／NAA在脑肿瘤复发和放射性脑损伤之间有统计学差异（P〈0．05），脑肿瘤复发与放射性脑损伤间NAA／Cr之间无统计学差异（P〉0．05）。结论多体素质子MRS对脑肿瘤放射治疗后的脑损伤及脑肿瘤复发的评估和鉴别诊断有重要临床价值。

Clinic applications of Multivoxel Proton MR SPectroscopy in the Differentiation between Radiation-Induced Brain Injury and Tumor Recurrence In the course of the radiotherapy

Objective To evalue clinical significance of 1H-MRS in differentical diagnosis and clinical assessment between radiation-induced brain injury and tumor recurrence.Methods 22 Patients with astroeytie or metastatie tumors,which were previously treated with radiotherapy,had new contrast-enhancing areas in the Perilesional brain.There are 14 men and 8 women,20-66 years old,mean age 42.9 years.They included 16 cases of astrocytic tumors and 6 cases of metastatie brain tumor.Multivoxel 1H-MRS examnations were per...