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目的:评估磁共振波谱成像(Proton Magnetic Resonance Spectroscopy,1H-MRS)联合磁共振扩散加权成像(Diffusion Weighted Imaging,DWI)在鉴别脑胶质瘤及孤立的脑转移瘤中的作用。方法:应用3.0T磁共振扫描仪,对临床手术确诊及组织病理学诊断证实的49例脑肿瘤患者(35例多形性胶质母细胞瘤,14例脑转移瘤)进行常规磁共振成像、磁共振波谱成像及磁共振扩散加权成像,并并对获得的数据进一步测量瘤内及瘤周区的代谢比、N-乙酰天门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)值以及表观弥散系数(ADC值),分析两肿瘤组之间不同参数的统计学差异。此外,我们研究了感兴趣区域(ROI)的大小对肿瘤区域的病变扩散性能潜在影响。结果:胶质母细胞瘤瘤周N-乙酰天门冬氨酸(NAA)、肌酸(Cr),胆碱(Cho)/Cr,Cho/NAA和r CBV显著高于颅内转移瘤(P<0.05);ADC值在两肿瘤组之间无显著差异(P>0.05)。结论:在瘤周区1H-MRS有助于鉴别胶质母细胞瘤与单发的脑转移瘤。在瘤内扩散性的定量特性依赖ROI大小的设置。
Objective: To evaluate the role of 1H MRS and Diffusion Weighted Imaging (DWI) in the differential diagnosis of brain gliomas and solitary brain metastases. Methods: A total of 49 brain tumor patients (35 cases of glioblastoma multiforme and 14 cases of brain metastases) confirmed by clinical diagnosis and histopathology were studied by conventional magnetic resonance imaging (MRI) with 3.0T magnetic resonance scanner. MR spectroscopy and MR diffusion weighted imaging, and the data obtained further measurement of tumor and peritubular area metabolic ratio, N-acetyl aspartate (NAA), choline (Cho), creatine (Cr ) Values and apparent diffusion coefficient (ADC value) were calculated and the statistical differences between the two tumor groups were analyzed. In addition, we investigated the potential impact of the size of the region of interest (ROI) on the spread of lesions in the tumor area. Results: NAA, Cr, Cho / Cr, Cho / NAA and r CBV in glioblastoma were significantly higher than those in intracranial metastases (P < 0.05). There was no significant difference in ADC value between the two tumor groups (P> 0.05). Conclusion: 1H-MRS in the peritumoral region is helpful to differentiate glioblastoma from solitary brain metastases. The quantitative properties of diffusivity in the tumor depend on the size of the ROI set.