摘要
目的评价二维氢质子磁共振波谱(2D1H-MRS)对胶质瘤术后复发和放射性脑损伤的鉴别作用。方法应用Siemens3.0TMR对35例脑胶质瘤术后放疗后常规MR检查出现新强化灶患者行2D1H-MRS分析。观察病变强化区及水肿区主要代谢物,计算代谢物比值(NAA、Cho、Cr、Cho/Cr、Cho/NAA、NAA/Cr)比较各代谢物比值在肿瘤复发和放射性脑损伤患者间的差异。结果35例中,肿瘤复发20例,放射性脑损伤15例,经组织学证实23例,经临床及影像随访证实12例。肿瘤复发病变强化区平均Cho/Cr和Cho/NAA比值显著高于放射性损伤,平均NAA/Cr比值显著低于放射性脑损伤;肿瘤复发病变水肿区平均Cho/Cr和Cho/NAA比值显著高于放射性脑损伤,平均NAA/Cr在两者间的差异无统计学意义。根据病变强化区代谢物比值ROC曲线,将Cho/Cr和Cho/NAA比值中任意一个或两个大于1.77作为肿瘤复发的判断标准,2D1H-MRS对胶质瘤术后复发的诊断敏感度和特异度分别为90.00%(18/20)和93.33%(14/15),准确率为91.43%(32/35)。结论2D1H-MRS对胶质瘤术后复发和放射性脑损伤具有重要鉴别价值。
Objective To evaluate the differentiated effectiveness of two-dimensional proton MR spectroscopy （2D 1H-MRS） to post-operative recurrent glioma and radiation injury. Methods Conventional MR and 2D 1H-MRS examinations were performed with Siemens 3.0T MR system for patients with recurrent contrast-enhancing lesions at the site of the treated glioma. The metabolite peaks were measured at the regions of enhanced nodule and edema,including N-acetylaspartate （NAA）,choline-containing compounds （Cho） and creatine （Cr）,while the Cho/Cr,Cho/NAA,NAA/Cr ratios were calculated. The new lesions were proved with histo-pathologic examination in 23 patients and clinical-imaging following-up in 12 patients. Recurrent gliomas were found in 20 patients,and radiation injury in 15 patients. Each mean metabolite ratio above was compared between two lesion types. Results At contrast-enhancing regions and edema regions,the mean Cho/Cr and Cho/NAA ratios were all significantly higher in patients with tumor recurrence compared with those with radiation injury. Tthe mean NAA/Cr ratio was significantly lower in patients with tumor recurrence compared with that with radiation injury at contrast-enhancing regions,but no significant difference was found at edema regions. Taking Cho/Cr and （or） Cho/NAA ratios 1.77 based on ROC curves of metabolite ratios as standards,the diagnostic sensitivity,specificity and accuracy was 90.00% （18/20）,93.33% （14/15） and 91.43% （32/35）,respectively. Conclusion 2D 1H-MRS is a valuable method to distinguish postoperative recurrent glioma and radiation injury.
出处
《中国医学影像技术》
CSCD
北大核心
2010年第4期639-642,共4页
Chinese Journal of Medical Imaging Technology
关键词
胶质瘤
复发
放射治疗
磁共振波谱成像
Glioma
Recurrence
Radiation therapy
Magnetic resonance spectroscopy
