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[目的]探讨1H-MRS在预测各级别胶质瘤浸润范围及判断肿瘤级别的临床应用价值。[方法]选取行术前MR检查以及1H-MRS检查的脑胶质瘤患者62例,另设20例正常成人为对照组。比较不同级别患者肿瘤组织、肿瘤周围组织、不同周围水肿组间的Cho/Cr、NAA/Cho、NAA/Cr比值。[结果 ]高级别、低级别组肿瘤组织及对照组3组间NAA/Cr、Cho/Cr和NAA/Cho比值差异有统计学意义(P<0.05)。不同组间瘤周组织NAA/Cr、Cho/Cr和NAA/Cho比值差异有统计学意义(P<0.05)。肿瘤周围有水肿组的肿瘤组织、瘤周组织与对照组间的NAA/Cr、Cho/Cr和NAA/Cho比值差异均有统计学意义(P<0.05)。[结论 ]1H-MRS能在分子水平上反映肿瘤的胆碱、脂质等化合物代谢的异常变化,可为胶质瘤级别及肿瘤浸润范围判断提供参考依据。
[Objective] To investigate the clinical value of 1H-MRS in predicting the extent of glioma invasion and determining tumor grade. [Methods] Sixty-two patients with glioma who underwent preoperative MR examination and 1H-MRS examination were selected, and another 20 normal adults were selected as the control group. The ratios of Cho / Cr, NAA / Cho and NAA / Cr were compared between tumor tissues, peri-tumor tissues and different surrounding edema groups. [Results] The ratios of NAA / Cr, Cho / Cr and NAA / Cho in high grade, low grade tumor tissues and control group were statistically different (P <0.05). There were significant differences in NAA / Cr, Cho / Cr and NAA / Cho ratio between different groups (P <0.05). There were significant differences in NAA / Cr, Cho / Cr and NAA / Cho ratios between the tumor tissue with edema around the tumor and the tumor surrounding tissue and the control group (P <0.05). [Conclusion] 1H-MRS can reflect the abnormal changes of tumor metabolism of choline, lipid and other compounds at the molecular level, which can provide a reference for judging glioma grade and tumor infiltration range.