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目的探讨二维化学位移氢质子磁共振波谱(2D CSI1H-MRS)对胶质瘤、转移瘤、脑膜瘤的鉴别诊断价值。资料与方法回顾性分析经临床诊断或经手术病理证实的90例患者的MRI及MRS资料,包括胶质瘤45例,转移瘤23例,脑膜瘤22例。计算瘤体及瘤周水肿区的Cho、Cr、NAA的浓度及Cho/Cr、NAA/Cr、NAA/Cho的比值。结果(1)胶质瘤、转移瘤、脑膜瘤瘤体区的NAA/Cho分别为0.41±0.19、0.56±0.15、0.15±0.07,三组差异均有统计学意义(P<0.05);(2)胶质瘤、转移瘤、脑膜瘤瘤周水肿区的Cho浓度分别为0.40±0.16、0.26±0.09、0.13±0.07,3组差异均有显著统计学意义(P<0.01),胶质瘤显著高于其他两者,当取Cho>0.45时,MRS区分胶质瘤的特异性、敏感性、阳性预测值、阴性预测值分别为83%、94%、77.3%、85.7%。结论2D CSI1H-MRS对胶质瘤、转移瘤、脑膜瘤的鉴别诊断有重要意义。
Objective To investigate the differential diagnosis of glioma, metastatic tumor and meningioma by two-dimensional chemical shift hydrogen proton magnetic resonance spectroscopy (2D CSI1H-MRS). Materials and Methods MRI and MRS data of 90 patients confirmed clinically or surgically and pathologically were retrospectively analyzed, including 45 gliomas, 23 metastases and 22 meningiomas. The concentrations of Cho, Cr and NAA and the ratios of Cho / Cr, NAA / Cr and NAA / Cho in the tumor and peritumoral edema area were calculated. Results (1) NAA / Cho in gliomas, metastases and meningiomas were 0.41 ± 0.19, 0.56 ± 0.15 and 0.15 ± 0.07, respectively, with statistical significance (P <0.05) ) Cho in glioma, metastasis and meningioma edema were 0.40 ± 0.16,0.26 ± 0.09,0.13 ± 0.07 respectively, the difference was statistically significant (P <0.01), glioma was significant The specificity, sensitivity, positive predictive value and negative predictive value of MRS for differentiating gliomas were 83%, 94%, 77.3% and 85.7% respectively when Cho> 0.45. Conclusion 2D CSI1H-MRS is of great significance in the differential diagnosis of gliomas, metastases and meningioma.