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目的探讨增强后多体素氢质子磁共振波谱(1H-MRS)对颅内常见肿瘤的鉴别诊断价值。资料与方法49例颅内常见肿瘤患者行增强后多体素1H-MRS检查,其中胶质瘤16例,单发转移瘤19例,脑膜瘤14例。测量计算3种肿瘤强化区、强化边缘区及对侧正常脑组织的代谢物比值:胆碱/肌酸(Cho/Cr)、N-乙酰天门冬氨酸/胆碱(NAA/Cho)、胆碱/对侧正常脑组织肌酸(Cho/Cr-n)和胆碱/对侧正常脑组织胆碱(rCho),并进行比较分析。结果单发转移瘤与胶质瘤、单发转移瘤与脑膜瘤以及胶质瘤与脑膜瘤强化边缘区之间NAA/Cho比值分别为2.4434±1.636、0.4762±0.278、1.0416±0.240,Cho/Cr-n比值分别为0.5444±0.457、1.0919±0.328、1.1597±0.342,rCho比值分别为0.5405±0.497、1.1761±0.423、1.3436±0.566,Cho/Cr比值分别为0.9105±0.414、1.6208±0.230、1.0489±0.260;转移瘤与脑膜瘤间除Cho/Cr外差异均有显著统计学意义(P<0.01),胶质瘤与脑膜瘤之间除Cho/Cr(P<0.01)外差异均无统计学意义(P>0.05)。强化区之间三者NAA/Cho比值分别为0.4550±0.240、0.2436±0.220、0.1415±0.112,Cho/Cr-n比值分别为0.9149±0.294、1.5182±0.935、1.8115±0.804,rCho比值分别为0.9129±0.304、1.5426±0.808、1.7464±0.504,Cho/Cr比值分别为4.3527±2.509、3.1709±2.197、4.9518±3.716;转移瘤与胶质瘤、脑膜瘤比较除Cho/Cr外差异均有显著统计学意义(P<0.01),而胶质瘤与脑膜瘤之间差异均无统计学意义(P>0.05)。结论增强后多体素1H-MRS对脑肿瘤的鉴别诊断有重要的临床应用价值。
Objective To investigate the differential diagnosis of common intracranial tumors by enhanced multi-voxel proton magnetic resonance spectroscopy (1H-MRS). Materials and Methods 49 cases of common intracranial tumor patients underwent enhanced multi-voxel 1H-MRS examination, including 16 cases of glioma, 19 cases of solitary metastasis and 14 cases of meningioma. The ratio of metabolites in the three kinds of tumor-strengthening area, the enhanced marginal area and the contralateral normal brain tissue were calculated and measured: Cho / Cr, NAA / Cho, Basal / contralateral normal brain creatine (Cho / Cr-n) and choline / contralateral normal brain tissue choline (rCho) were compared and analyzed. Results The ratios of NAA / Cho between solitary metastasis and glioma, solitary metastasis and meningioma and between glioma and meningioma enhanced marginal zone were 2.4434 ± 1.636, 0.4762 ± 0.278 and 1.0416 ± 0.240, respectively. Cho / Cr -n ratios were 0.5444 ± 0.457,1.0919 ± 0.328,1.1597 ± 0.342, rCho ratios were 0.5405 ± 0.497,1.1761 ± 0.423,1.3436 ± 0.566, Cho / Cr ratios were 0.9105 ± 0.414, 1.6208 ± 0.230, 1.0489 ± 0.260 (P <0.01). There was no significant difference between Cho / Cr (P <0.01) and gliomas and meningioma except for Cho / Cr (P <0.01) P> 0.05). The NAA / Cho ratios of the three regions were 0.4550 ± 0.240,0.2436 ± 0.220,0.1415 ± 0.112 respectively, and the ratios of Cho / Cr-n were 0.9149 ± 0.294, 1.5182 ± 0.935 and 1.8115 ± 0.804 respectively, and the rCho ratios were 0.9129 ± 0.304,1.5426 ± 0.808,1.7464 ± 0.504 and Cho / Cr ratios were 4.3527 ± 2.509,3.1709 ± 2.197 and 4.9518 ± 3.716, respectively. There was significant difference between Cho / Cr and glioma and meningiomas (P <0.01), but there was no significant difference between glioma and meningioma (P> 0.05). Conclusion Enhanced multi-voxel 1H-MRS has important clinical value in the differential diagnosis of brain tumors.