氢质子磁共振波谱分析鉴别脑低级别胶质瘤、脑炎与脑梗死的临床研究
发布时间：2018-10-19 20:23
【摘要】：目的:探讨1H-MRS对脑低级别胶质瘤与脑炎、脑梗死的鉴别诊断价值。 方法：使用飞利浦3.0T磁共振系统对66例患者(其中低级别胶质瘤20例,脑炎26例,脑梗死20例)进行常规MRI平扫和增强扫描,并在病灶区及相应正常脑实质区设置感兴趣区进行单体素氢质子波谱成像。脑炎和脑梗死病例均为急性或亚急性期，均经临床治疗后随诊证实，脑低级别胶质瘤病例均经手术/活检病理证实。对三组患者的临床、影像学资料分别进行回顾性分析比较。利用Function Tool软件对波谱数据进行分析，，分别计算三组患者1H-MRS病灶侧NAA/Cr、NAA/Cho、Cho/Cr、Cho/NAA以及正常区域相应代谢物比值变化。采用SPSS16.0统计分析软件对所得数据进行统计学分析。 结果： 1.低级别胶质瘤、脑炎、脑梗死与相应部位正常脑实质区的Cho/Cr、NAA/Cho、NAA/Cho、NAA/Cr值均有统计学差异(P＜0.05) 2.脑低级别胶质瘤与脑炎、脑梗死的Cho／Cr、Cho／NAA、NAA／Cho值之间的差别具有高度显著性(P0.01)，而脑梗死的各项指标与脑炎之间的差别无显著性(P0.05) 3. Cho/Cr、Cho/NAA、NAA/Cr、NAA/Cho的ROC曲线下面积分别为0.852、0.915、0.258、0.093。其中Cho/Cr取界值为2.47时，鉴别脑低级别胶质瘤和非肿瘤病变（脑炎、脑梗死）的灵敏度为93㳠，特异度为77.8㳠；Cho/NAA取界值为3.18时，鉴别脑低级别胶质瘤和非肿瘤病变（脑炎、脑梗死）的灵敏度为93㳠，特异度为88.9㳠 结论： 1.Cho／Cr、Cho／NAA、NAA／Cho能鉴别脑低级胶质瘤与脑梗死、脑炎。 2.脑炎与脑梗死比较，各项指标均无鉴别诊断价值。 3.MRS的量化指标Cho／Cr、Cho／NAA对鉴别诊断脑低级胶质瘤与脑梗死、脑炎有一定参考价值。
[Abstract]:Objective: to investigate the value of 1H-MRS in the differential diagnosis of low grade gliomas from encephalitis and cerebral infarction. Methods: a total of 66 patients (20 cases of low grade glioma, 26 cases of encephalitis and 20 cases of cerebral infarction) underwent conventional MRI plain scan and enhanced scanning with Philips 3.0T magnetic resonance system. The region of interest was set up in the focus area and the corresponding normal brain parenchyma area. The cases of encephalitis and cerebral infarction were both acute or subacute, which were confirmed by follow up after clinical treatment, and those with low grade gliomas were confirmed by operation / biopsy. The clinical and imaging data of the three groups were retrospectively analyzed and compared. The spectral data were analyzed by Function Tool software, and the changes of the ratio of metabolites in the lesion side of 1H-MRS and the corresponding metabolites in the normal region were calculated in three groups of patients. SPSS16.0 statistical analysis software was used to analyze the data. Results: 1. The Cho/Cr,NAA/Cho,NAA/Cr values of low grade glioma, encephalitis, cerebral infarction and normal cerebral parenchyma were significantly different (P < 0. 05) 2. The difference of Cho/Cr,Cho/NAA,NAA/Cho between low grade glioma and encephalitis and cerebral infarction was significant (P0. 01), but there was no significant difference between the indexes of cerebral infarction and encephalitis (P0.05). The area under the ROC curve of Cho/Cr,Cho/NAA,NAA/Cr,NAA/Cho is 0.852O0.915U 0.258N 0.093, respectively. When the threshold of Cho/Cr is 2.47, the sensitivity of differentiating low-grade gliomas from non-neoplastic lesions (encephalitis, cerebral infarction) is 93U, the specificity is 77.8%, and the threshold value of Cho/Cr / NAA is 3.18, and the difference between low-grade gliomas and non-tumor lesions (encephalitis) is 3.18. The sensitivity and specificity of cerebral infarction were 93? Conclusion: 1. Chor / Cro / NAA / Cho can distinguish low grade glioma from cerebral infarction and encephalitis. 2. Compared with cerebral infarction, there is no value in differential diagnosis of encephalitis and cerebral infarction. Cho/Cr,Cho/NAA, a quantitative index of 3.MRS, has certain reference value in differential diagnosis of cerebral glioma and cerebral infarction and encephalitis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.41;R512.3;R743.3
本文编号：2282260
[Abstract]:Objective: to investigate the value of 1H-MRS in the differential diagnosis of low grade gliomas from encephalitis and cerebral infarction. Methods: a total of 66 patients (20 cases of low grade glioma, 26 cases of encephalitis and 20 cases of cerebral infarction) underwent conventional MRI plain scan and enhanced scanning with Philips 3.0T magnetic resonance system. The region of interest was set up in the focus area and the corresponding normal brain parenchyma area. The cases of encephalitis and cerebral infarction were both acute or subacute, which were confirmed by follow up after clinical treatment, and those with low grade gliomas were confirmed by operation / biopsy. The clinical and imaging data of the three groups were retrospectively analyzed and compared. The spectral data were analyzed by Function Tool software, and the changes of the ratio of metabolites in the lesion side of 1H-MRS and the corresponding metabolites in the normal region were calculated in three groups of patients. SPSS16.0 statistical analysis software was used to analyze the data. Results: 1. The Cho/Cr,NAA/Cho,NAA/Cr values of low grade glioma, encephalitis, cerebral infarction and normal cerebral parenchyma were significantly different (P < 0. 05) 2. The difference of Cho/Cr,Cho/NAA,NAA/Cho between low grade glioma and encephalitis and cerebral infarction was significant (P0. 01), but there was no significant difference between the indexes of cerebral infarction and encephalitis (P0.05). The area under the ROC curve of Cho/Cr,Cho/NAA,NAA/Cr,NAA/Cho is 0.852O0.915U 0.258N 0.093, respectively. When the threshold of Cho/Cr is 2.47, the sensitivity of differentiating low-grade gliomas from non-neoplastic lesions (encephalitis, cerebral infarction) is 93U, the specificity is 77.8%, and the threshold value of Cho/Cr / NAA is 3.18, and the difference between low-grade gliomas and non-tumor lesions (encephalitis) is 3.18. The sensitivity and specificity of cerebral infarction were 93? Conclusion: 1. Chor / Cro / NAA / Cho can distinguish low grade glioma from cerebral infarction and encephalitis. 2. Compared with cerebral infarction, there is no value in differential diagnosis of encephalitis and cerebral infarction. Cho/Cr,Cho/NAA, a quantitative index of 3.MRS, has certain reference value in differential diagnosis of cerebral glioma and cerebral infarction and encephalitis.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R739.41;R512.3;R743.3
【参考文献】
相关期刊论文 前1条
1 郭秀海,吴卫平,朱克;假瘤型炎性脱髓鞘病的临床及病理[J];脑与神经疾病杂志;2002年04期
本文编号：2282260
本文链接：https://www.wllwen.com/yixuelunwen/chuanranbingxuelunwen/2282260.html
最近更新
教材专著
