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目的探讨超高场31P-MRS对骨与软组织肿瘤的成像特点。方法对病理证实的骨与软组织肿瘤41例用磷表面线圈进行31P-MRS分析,测量波谱中各代谢产物的峰下面积,分别以三磷酸腺苷β峰(β-ATP)、三磷酸核苷(NTP)、磷酸肌酸(Pcr)为参照计算各代谢产物的相对比值,根据无机磷(Pi)相对于Pcr化学位移的变化计算细胞内pH值,进行相对定量分析。根据峰下面积计算各代谢产物与β-ATP、三磷酸核苷(NTP=ATP+Pi+Pcr)、Pcr的相对值PME/β-ATP、PDE/β-ATP、β-ATP/Pi、PME/NTP、PDE/NTP、Pcr/Pi及Pcr/PME。并运用SPSS11.5 for Windows软件包进行统计学处理,采用多个独立样本的非参数检验。结果良、恶性肿瘤组的Pcr/PME、PME/NTP较对照组均有显著性差异(P<0.05)。良、恶性肿瘤组PME/β-ATP、PME/NTP的差异有显著性意义(P<0.05)。与正常组比较,良、恶性肿瘤组的PME和PDE及Pi峰升高,Pcr峰降低。结论31P-MRS测得的Pcr/PME、PME/NTP与骨、软组织肿瘤相关,PME/β-ATP、PME/NTP在骨与软组织肿瘤的诊断和鉴别诊断中发挥重要的作用。
Objective To investigate the imaging features of bone and soft tissue tumors in hyper-field 31P-MRS. Methods 41 cases of pathologically confirmed bone and soft tissue tumors were analyzed by 31P-MRS using a surface-activated-phosphorous (PPS) coil. The area under the peak of each metabolite in the spectrum was measured and the peak area of each metabolite was determined by β-ATP, NTP, , Creatine phosphate (Pcr) as a reference to calculate the relative ratio of each metabolite, according to inorganic phosphorus (Pi) relative to the Pcr chemical shift of the intracellular pH value calculation, relative quantitative analysis. According to the area under the peak, the relative values of PME / β-ATP, PDE / β-ATP, β-ATP / Pi and PME / NTP, PDE / NTP, Pcr / Pi and Pcr / PME. And SPSS11.5 for Windows software package for statistical analysis, using a number of independent samples of non-parametric test. Results The Pcr / PME and PME / NTP in benign and malignant tumors were significantly different from those in the control group (P <0.05). The difference of PME / β-ATP, PME / NTP between benign and malignant tumors was significant (P <0.05). Compared with the normal group, the PME and PDE and Pi peaks of benign and malignant tumors increased and the Pcr peak decreased. Conclusions The Pcr / PME and PME / NTP measured by 31P-MRS are correlated with bone and soft tissue tumors. PME / β-ATP and PME / NTP play an important role in the diagnosis and differential diagnosis of bone and soft tissue tumors.