| 张丹,刘珺迪,王金英,田慧,姜春晖,贾文霄,王俭.1H-MRS定量分析鉴别诊断脑泡型包虫病与脑转移瘤[J].中国医学影像技术,2019,35(5):659~663 |
| 1H-MRS定量分析鉴别诊断脑泡型包虫病与脑转移瘤 |
| Quantitative analysis of 1H-MRS in differential diagnosis of cerebral alveolar echinococcosis and brain metastases |
| 投稿时间：2018-09-12 修订日期：2019-01-30 |
| DOI：10.13929/j.1003-3289.201809067 |
| 中文关键词: 脑 棘球蚴病 肿瘤转移 磁共振波谱学 |
| 英文关键词:brain echinococcosis neoplasm metastasis magnetic resonance spectroscopy |
| 基金项目:新疆维吾尔自治区重点研发计划项目（2016B03052）。 |
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| 中文摘要: |
| 目的 探讨1H-MRS鉴别诊断脑泡型包虫病和脑转移瘤的价值。方法 收集经术后病理及临床随访确诊为脑泡型包虫病和脑转移瘤患者各20例，分别进行脑常规MR、增强和1H-MRS扫描。测量脑泡型包虫病、脑转移瘤病灶实质区、病灶水肿区及对侧正常脑实质N-乙酰天门冬氨酸（NAA）、胆碱（Cho）、肌酸（Cr）、乳酸和脂质峰（Lip+Lac）峰值，并计算Cho/Cr、Cho/NAA、（Lip+Lac）/Cr。结果 脑泡型包虫病病灶实质区Cho、Cho/Cr、Cho/NAA显著低于脑转移瘤，Lip+Lac、（Lip+Lac）/Cr明显高于脑转移瘤（P均<0.05）。脑泡型包虫病与脑转移瘤病灶实质区Cr、NAA，水肿区Cho、Cr、NAA、Lip+Lac、Cho/Cr、Cho/NAA、（Lip+Lac）/Cr差异均无统计学意义（P均>0.05）。脑泡型包虫病实质区Cr、NAA峰及水肿区NAA显著低于对侧正常脑实质，实质区及水肿区Lip+Lac、Cho/Cr、Cho/NAA、（Lip+Lac）/Cr明显高于对侧正常脑实质（P均<0.05）。脑转移瘤病灶实质区Cho、Lip+Lac、Cho/Cr、Cho/NAA、（Lip+Lac）/Cr及水肿区Cho/NAA、（Lip+Lac）/Cr明显高于对侧正常脑实质，实质区NAA峰低于对侧正常脑实质（P均<0.05）。结论 1H-MRS技术可显示脑泡型包虫病和脑转移瘤病灶及病灶周围水肿区组织代谢的特点，为鉴别诊断提供客观依据。 |
| 英文摘要: |
| Objective To explore the value of 1H-MRS in differential diagnosis of cerebral alveolar echinococcosis and brain metastases. Methods Twenty patients with alveolar echinococcosis and 20 patients with brain metastasis confirmed by postoperative pathology and clinical follow-up were collected, and routine and enhanced MR and 1H-MRS were performed, respectively. N-acetylaspartic acid (NAA), choline (Cho), creatine (Cr), lactic acid and lipids peaks (Lip+Lac) were observed in the parenchymal areas, edema areas and contralateral normal brain parenchyma of alveolar echinococcosis and brain metastases, and the ratios of Cho/Cr, Cho/NAA and (Lip+Lac)/Cr were calculated. Results The values of Cho, Cho/Cr and Cho/NAA in parenchyma of alveolar echinococcosis were significantly lower than those of brain metastases, and Lip+Lac, (Lip+Lac)/Cr were significantly higher than those of brain metastases (all P<0.05). There was no significant difference in Cr, NAA of parenchyma, Cho, Cr, NAA, Lip+Lac, Cho/Cr, Cho/NAA, nor (Lip+Lac)/Cr of edema between alveolar echinococcosis and brain metastases (all P>0.05). The peaks of Cr, NAA in the parenchyma area and NAA in the edema area of alveolar echinococcosis were significantly lower than those in the contralateral normal brain, while Lip+Lac, Cho/Cr, Cho/NAA, (Lip+Lac)/Cr in the parenchyma and edema area were significantly higher than those in the contralateral normal brain parenchyma (all P<0.05). Parenchyma area Cho, Lip+ Lac peak, Cho/Cr, Cho/NAA, (Lip+Lac)/Cr and edema area Cho/NAA, (Lip+Lac)/Cr were significantly higher than those in the contralateral normal brain parenchyma, while NAA peak in the parenchyma was lower than that in the contralateral normal brain parenchyma (all P<0.05). Conclusion 1H-MRS technique can display characteristics of tissue metabolism in the lesions and surrounding edema areas of alveolar echinococcosis and brain metastases, and provide objective basis for differential diagnosis. |
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