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目的探讨多体素MRS在不同级别星形细胞瘤术前诊断的应用价值。方法搜集22例病理证实的脑星形细胞瘤,分为高、低级别2组,行MR常规、增强扫描及MRS检查,比较Cho/Cr、NAA/Cr、Cho/NAA比值及Lac、Lip情况。结果高级别组表现为Cho明显增高,NAA及Cr明显降低,低级别组表现为Cho轻到中度不等增高和NAA不同程度的降低,高、低级别组间Cho/Cr、NAA/Cr以及Cho/NAA比值差别有意义。肿瘤周边水肿区与对侧正常脑组织间Cho/Cr、Cho/NAA比值差别有意义,NAA/Cr比值差别无统计学意义。高级别组中有11例出现Lac峰,7例出现Lip峰,低级别组中仅有2例出现Lac峰,无Lip峰出现。结论多体素H-MRS在术前全面评价星形细胞瘤不同级别间的鉴别诊断及确定肿瘤边界形态方面有重要的临床意义。
Objective To investigate the value of multi-voxel MRS in the preoperative diagnosis of astrocytomas of different grades. Methods Totally 22 pathologically confirmed astrocytomas were enrolled in this study. The patients were divided into high and low grade 2 groups. The MR, routine scanning, MRS and MRS were performed. The ratios of Cho / Cr, NAA / Cr, Cho / NAA and Lac, . Results The results of high-grade group showed that Cho was significantly increased, NAA and Cr were significantly lower, low-grade group showed mild to moderate increase in Cho and NAA to varying degrees, high and low levels of Cho / Cr, NAA / Cr and Cho / NAA ratio difference makes sense. The ratio of Cho / Cr and Cho / NAA between the peripheral edema area and the contralateral normal brain tissue was significant, but the NAA / Cr ratio had no statistical significance. In the high-grade group, Lac peak occurred in 11 and Lip peak in 7 and low-grade Lac group only in 2, and no Lip peak appeared. Conclusions Multi-voxel H-MRS has important clinical significance in the preoperative evaluation of the differential diagnosis of astrocytoma at different levels and the determination of tumor border morphology.