| 徐俊玲,李永丽,连建敏,窦社伟,吴慧,冯敢生.二维氢质子磁共振波谱分析鉴别胶质瘤术后复发和放射性脑损伤[J].中国医学影像技术,2010,26(4):639~642 |
| 二维氢质子磁共振波谱分析鉴别胶质瘤术后复发和放射性脑损伤 |
| Differentiation of postoperative recurrent glioma and radiation injury with two-dimensional proton MR spectroscopy |
| 投稿时间：2009-08-20 修订日期：2010-01-04 |
| DOI： |
| 中文关键词: 胶质瘤 复发 放射治疗 磁共振波谱成像 |
| 英文关键词:Glioma Recurrence Radiation therapy Magnetic resonance spectroscopy |
| 基金项目: |
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| 摘要点击次数: 4106 |
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| 中文摘要: |
| 目的 评价二维氢质子磁共振波谱(2D 1H-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Siemens 3.0T MR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2D 1H-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,2D 1H-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 2D 1H-MRS对胶质瘤术后复发和放射性脑损伤具有重要鉴别价值。 |
| 英文摘要: |
| 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. |
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