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目的探讨磁共振波谱(Magnetic resonance spectroscopy,MRS)在脑干胶质瘤诊断中的意义。方法回顾性分析10例脑干胶质瘤的临床资料,肿瘤位于中脑1例,中脑脑桥1例,脑桥7例,延髓1例。均行MRS检查,对肿瘤区、肿瘤边缘区和正常对照区进行对照研究。结果MRS均显示肿瘤区N-乙酰天门冬氨酸(N-acetylaspartate,NAA)峰值下降,胆碱(Choline,Cho)峰上升。与肿瘤边缘区和正常对照区比较,肿瘤区NAA/Cr明显减低,Cho/Cr和Cho/NAA明显升高。星形细胞瘤4例,间变性星形细胞瘤1例,胶质母细胞瘤2例;另3例根据临床特点和影像学表现诊断为脑干胶质瘤。结论MRS可检测到脑干胶质瘤的代谢改变,具有无创、敏感、诊断准确的特点。
Objective To investigate the significance of magnetic resonance spectroscopy (MRS) in the diagnosis of brain stem glioma. Methods The clinical data of 10 cases of brain stem glioma were retrospectively analyzed. The tumor was located in midbrain in 1 case, midbrain pontine in 1 case, pontine in 7 cases and medulla oblongata in 1 case. MRS were performed on the tumor area, tumor marginal zone and normal control area for controlled study. Results MRS showed that the peak value of N-acetylaspartate (NAA) and the peak of Choline (Cho) increased in tumor area. Compared with the marginal zone and normal control zone, NAA / Cr in the tumor area was significantly decreased and Cho / Cr and Cho / NAA were significantly increased. Astrocytoma in 4 cases, anaplastic astrocytoma in 1 case, glioblastoma in 2 cases; the other 3 cases based on clinical features and imaging diagnosis of brain stem glioma. Conclusion MRS can detect the metabolism of brain stem glioma changes, with noninvasive, sensitive, accurate diagnosis.