氢质子磁共振波谱对脑低级别胶质瘤与病毒性脑炎的鉴别诊断价值

发布时间：2018-03-11 13:33

本文选题：脑低级别胶质瘤　切入点：病毒性脑炎　出处：《临床神经病学杂志》2015年05期 　论文类型：期刊论文

【摘要】：目的探讨氢质子磁共振波谱(1H-MRS)对病毒性脑炎和脑低级别胶质瘤的鉴别诊断价值。方法使用飞利浦3.0 T MR系统对低级别胶质瘤(胶质瘤组)20例,病毒性脑炎(脑炎组)25例进行常规MRI平扫和增强扫描,所有病例均在病灶区及相应正常脑实质区设置感兴趣区进行1H-MRS成像。利用Function Tool软件对波谱数据进行分析,分别检测病灶侧和对侧相应正常脑区MRS的N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)值,并进行比较。结果两组正常侧与相应部位病灶侧的Cho/Cr、Cho/NAA、NAA/Cho、NAA/Cr比较差异有统计学意义(均P0.01)。两组间病灶侧Cho/Cr、Cho/NAA、NAA/Cho比较差异有统计学意义(均P0.01)。两组间正常侧Cho/Cr、Cho/NAA、NAA/Cho、NAA/Cr比较差异无统计学意义(均P0.05)。Cho/Cr的ROC曲线下面积为0.926,其中Cho/Cr取界值为2.46时,鉴别脑低级别胶质瘤与病毒性脑炎的灵敏度为91.7%,特异度为88.9%。结论1H-MRS对病毒性脑炎和脑低级别胶质瘤的鉴别诊断有重要临床价值,其中以Cho/Cr比值鉴别二者的参考价值最大。
[Abstract]:Objective to investigate the value of 1H-MRS in differential diagnosis of viral encephalitis and low-grade gliomas. Methods 20 cases of low-grade gliomas (glioma group) were treated with Philips 3.0T Mr system. 25 cases of viral encephalitis (encephalitis group) underwent conventional MRI plain scan and enhanced scanning. All cases were examined by 1H-MRS imaging in the focus area and the corresponding normal parenchyma area. The spectral data were analyzed by Function Tool software. The values of N-acetylaspartate (NAA), creatine (Cr), choline (Chol) in the MRS of the lesion side and the contralateral normal brain region were measured. Results there was a significant difference between the two groups in the normal side and the corresponding lesion side (P < 0.01). There was no statistical difference between the two groups in the Cho-Cro / NAA / NAA / NAA / NAA / Cr of the normal side (all P0.01.There was no statistical difference between the normal side of the two groups in the Cho-CrCrOP-NAA / NAA / NAA / NAA / Cr ratio of the two groups (all P0.01.There was no statistical difference between the two groups in the comparison of the two groups' normal side (P < 0.01); the normal side of the two groups was the normal side; the difference was not statistically significant in the comparison between the two groups. The area under the ROC curve is 0.926, where the Cho/Cr threshold is 2.46. The sensitivity of differentiating low grade gliomas from viral encephalitis was 91.7 and the specificity was 88.9.Conclusion 1H-MRS has important clinical value in the differential diagnosis of viral encephalitis and low grade gliomas, in which the ratio of Cho/Cr is the best.
【作者单位】：广西医科大学第一附属医院神经内科;
【基金】：广西卫生厅自筹经费科研课题(桂卫Z2015267)
【分类号】：R739.4;R512.3

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