1H-MRS在原发性中枢神经系统淋巴瘤与高级别胶质瘤鉴别诊断中的价值

发布时间：2018-03-09 06:29

本文选题：磁共振波谱　切入点：淋巴瘤　出处：《福建医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的探讨单体素不同回波时间（TE=30/135ms）和多体素长回波（TE=135ms）MRS在原发性神经系统淋巴瘤（PCNSL）与高级别胶质瘤（HGG）鉴别诊断中的价值。材料与方法回顾性分析19例PCNSL（13例经病理证实，6例经诊断性治疗确诊）和22例HGG（均经病理证实）患者影像资料。所有患者均接受Siemens Verio3.0T磁共振仪检查，均行常规MRI平扫+增强。19例PCNSL均行单体素短和长回波MRS检查，其中15例行多体素长回波MRS检查。22例HGG均行单体素短和长回波MRS及多体素长回波MRS检查。分析不同TE时间单体素MRS在瘤体中的不同代谢物相对比值，同时分析多体素长回波MRS在瘤体及瘤周中的不同代谢物相对比值。采用独立样本t检验和ROC曲线分析两者的代谢物指标，选择SPSS19.0软件，P＜0.05有统计学意义。结果单体素短回波MRS的Cho/Cr和NAA/Cr在PCNSL与HGG的鉴别诊断中均有统计学意义（P＜0.05）；Cho/NAA和Lac+Lip/Cr在两者的鉴别诊断中均无统计学意义（P＞0.05）。单体素长回波MRS的Cho/Cr、NAA/Cr和Cho/NAA在两者的鉴别诊断中均有统计学意义（P＜0.05）。多体素长回波MRS瘤体的Cho/Cr、NAA/Cr和Cho/NAA在两者的鉴别诊断中均无统计学意义（P＞0.05）；瘤周的Cho/Cr、NAA/Cr和Cho/NAA在两者的鉴别诊断中均无统计学意义（P＞0.05）。选择ROC曲线的youden指数最大值作为鉴别诊断PCNSL与HGG的最佳临界点时，单体素短回波MRS的Cho/Cr、NAA/Cr在两者的鉴别诊断中的敏感性和特异性分别为57.9%和95.5%、68.4%和90.9%。单体素长回波MRS的Cho/Cr、NAA/Cr、Cho/NAA在两者的鉴别诊断中的敏感性和特异性分别为42.1%和100%、68.4%和55%、89.5%和59.1%。结论单体素MRS代谢物是鉴别诊断PCNSL与HGG的有效指标，，多体素长回波MRS鉴别诊断价值有限。
[Abstract]:Objective to investigate the value of different Hui Bo time (TE=30/135ms) and multivoxel long Hui Bo (TE=135ms) MRS in differential diagnosis of primary nervous system lymphoma (PCNSL) and high-grade glioma (HGG).
Materials and Methods Retrospective analysis of 19 cases of PCNSL (13 cases confirmed by pathology, 6 cases diagnosed by the diagnostic treatment) and 22 cases of HGG (confirmed by pathology) imaging data of patients. All patients underwent Siemens Verio3.0T MRI examination, underwent conventional MRI scan and enhanced.19 cases of PCNSL underwent single in the short and long echo MRS examination, 15 cases underwent multi voxel long echo MRS.22 patients HGG underwent single voxel short and long echo MRS and multi voxel MRS long echo examination. TE analysis of different time of single voxel MRS metabolites in different tumor tissues and relative ratio, analysis of different metabolites of multi body long back wave MRS in tumor and peritumoral in relative ratio. Analysis of metabolite indicators of the two independent samples t test and ROC curve, SPSS19.0 software, P < 0.05 was statistically significant.
The results of single voxel short echo MRS Cho/Cr and NAA/Cr in the differential diagnosis of PCNSL and HGG were statistically significant (P < 0.05); Cho/NAA and Lac+Lip/Cr had no statistical significance in the differential diagnosis of (P > 0.05). Single voxel long echo MRS Cho/Cr, NAA/Cr and Cho/NAA had statistical significance in the differential the diagnosis of the two (P < 0.05). Multi voxel long echo MRS tumor Cho/Cr, NAA/Cr and Cho/NAA had no statistical significance in the differential diagnosis of (P > 0.05); peritumoral Cho/Cr, NAA/Cr and Cho/NAA had no statistical significance in the differential diagnosis of (P > 0.05) select the ROC curve. The maximum Youden index as the best critical point of differential diagnosis of PCNSL and HGG, single voxel short echo MRS Cho/Cr, sensitivity and specificity of NAA/Cr in the differential diagnosis of respectively 57.9% and 95.5%, 68.4% and 90.9%. single voxel long echo MRS Cho/Cr, NA The sensitivity and specificity of A/Cr and Cho/NAA in the differential diagnosis were 42.1% and 100%, 68.4% and 55%, 89.5% and 59.1%., respectively.
Conclusion monoxin MRS metabolite is an effective index for differential diagnosis of PCNSL and HGG, and the differential diagnosis of multibody long echo MRS is of limited value.

【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R445.2

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