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目的探讨多体素1H磁共振波谱(1H-MRS)在颅脑肿瘤强化周围区的代谢物改变特点及其鉴别诊断意义。方法脑肿瘤患者35例,多体素1H-MRS采集NAA、Cho、Cr、Lac、L ip、m I和A la峰,分别计算星形细胞瘤、转移瘤、脑膜瘤的肿瘤强化区、强化周围区和正常参照区域的代谢物浓度,计算不同脑肿瘤、同种脑肿瘤不同区域及高、低级胶质瘤各代谢物比值平均值,比较统计学差异,记录Lac、L ip、m I和A la是否出现。结果肿瘤强化区NAA/Cho、NAA/Cr和Cho/Cr平均值与正常参照区比较均有显著性差异(P<0.05);共出现17例Lac峰、7例L ip峰、6例A la峰和6例m I峰;强化周围区,三者的NAA/Cho、NAA/Cr、NAA/nCr、Cho/NAA值具显著性差异;良、恶性胶质瘤间,NAA/Cho、NAA/nCr、Cho/Cr和Cho/nCho值具有统计学差异(P<0.05)。结论多体素1H-MRS对肿瘤强化周围区域的评价,有助于星形细胞瘤与脑转移瘤、脑膜瘤的鉴别诊断及浸润范围的划定。
Objective To investigate the changes of metabolites of multi-voxel 1H magnetic resonance spectroscopy (1H-MRS) in the surrounding areas with enhanced brain tumor and its differential diagnostic significance. Methods 35 cases of brain tumor and NAA, Cho, Cr, Lac, Lp1, m I and A la peak were collected by multi-voxel 1H-MRS. The areas of astrocytoma, metastases and meningiomas were calculated, Peripheral area and normal reference area of the metabolite concentration, calculated in different brain tumors, the same brain tumor in different regions and high and low grade glioma metabolites ratio of the average, statistical differences were recorded Lac, L ip, m I and A la appears. Results There were significant differences in NAA / Cho, NAA / Cr and Cho / Cr between the two groups (P <0.05). There were 17 cases of Lac peak, 7 cases of Lp peak and 6 cases of A la NAA / Cho, NAA / nCr and Cho / NAA were significantly different between the three groups in the enhancement of surrounding area. There were significant differences in NAA / Cho, NAA / Cho and NAA / Cho ratios between benign and malignant gliomas, The nCr, Cho / Cr and Cho / nCho values had statistical significance (P <0.05). Conclusions Multi-voxel 1H-MRS can be used to evaluate the tumor-surrounding areas and help to differentiate astrocytomas from brain metastases and meningiomas and to define the extent of infiltration.