脑胶质瘤外科手术后辅助放疗的MR波谱随访研究

发布时间：2018-04-27 06:34

本文选题：神经胶质瘤 + 放射疗法　；参考：《放射学实践》2016年01期

【摘要】：目的:探讨脑胶质瘤外科手术后辅助放射治疗的MR波谱变化趋势和可能的病理学基础。方法:搜集23例经手术病理证实的胶质瘤患者,术后均接受辅助放射治疗,监测脑组织、部分病例的残留肿瘤及复发肿瘤的代谢物浓度的变化趋势,并与放疗结束时的自身数据进行比较。结果:放射野内脑组织NAA/Cr、Cho/Cr和NAA/Cho值逐步降低,至放疗结束后第3个月达最低水平,分别为1.83±0.16、1.27±0.10和1.02±0.15,然后逐渐升高至接近放疗前水平,分别为1.73±0.17、1.45±0.07和1.31±0.18,差异具有统计学意义(F值分别为305.20、50.62和266.68,P值均0.01)。7例残留瘤体中5例未复发,3种代谢物比值放疗后有所降低并保持在一定水平,2例复发者放疗结束后第12个月NAA/Cr、Cho/Cr和NAA/Cho值分别为0.20±0.13、3.45±0.11和0.12±0.10,表明肿瘤细胞增值活跃,代谢旺盛,高度提示肿瘤复发,与第二次手术病理结果具有较好的一致性。结论:磁共振波谱通过监测代谢物浓度变化,能无创性反映胶质瘤术后放疗脑损伤的修复过程,监测残留瘤体放疗后的生物活性,可为诊断肿瘤复发提供有价值的信息。
[Abstract]:Objective: to investigate the trend of Mr spectrum changes and the possible pathological basis of postoperative adjuvant radiotherapy for glioma. Methods: 23 patients with glioma confirmed by operation and pathology received adjuvant radiotherapy after operation to monitor the change trend of metabolite concentration of residual tumor and recurrent tumor in some cases. The data were compared with those at the end of radiotherapy. Results: the values of NAA / CrCho-Cr and NAA/Cho in brain tissue of radiation field decreased gradually, and reached the lowest level at the third month after radiotherapy (1.83 卤0.16 卤1.27 卤0.10 and 1.02 卤0.15, respectively), and then gradually increased to close to the pre-radiotherapy level. They were 1.73 卤0.17, 1.45 卤0.07 and 1.31 卤0.18, respectively. The difference was statistically significant (F = 305.20, 50.62, 266.68, P = 0.01g, respectively). The ratio of 3 metabolites in 5 cases without recurrence decreased after radiotherapy and kept at a certain level in 2 cases after radiotherapy. After 12 months, the values of NAA / Cr / Cr and NAA/Cho were 0.20 卤0.133.45 卤0.11 and 0.12 卤0.10, respectively. Metabolism is vigorous and highly indicative of tumor recurrence, which is in good agreement with the pathological results of the second operation. Conclusion: magnetic resonance spectroscopy can reflect the repair process of brain injury after radiotherapy and monitor the biological activity of residual tumor by monitoring the change of metabolite concentration, which can provide valuable information for the diagnosis of tumor recurrence.
【作者单位】：海南省人民医院放射科;海南省人民医院病理科;海南省人民医院放疗科;
【基金】：国家自然科学基金资助项目(81360233,81560282) 海南省重点科技项目(ZDXM20130069) 海南省自然科学基金项目(812154) 海南省卫生厅科研立项课题(2011-23,2012PT-19)
【分类号】：R739.41;R445.2

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