~1HMRS在鉴别脑内单发环形强化病变中的应用

发布时间：2018-11-25 07:34

【摘要】：目的分析3.0T氢质子磁共振波谱成像(1HMRS)在鉴别脑内单发环形强化病变中的应用。方法应用PHILIPS 3.0T磁共振扫描仪对65例在MRI增强扫描时表现为脑内单发环形强化病变的患者治疗前行1HMRS扫描,经病理证实或临床确诊为30例高级别胶质瘤、23例单发脑转移瘤和12例脑脓肿。分别测量病灶中心及周围水肿区的NAA、Cho及Cr峰的峰下面积,计算NAA/Cr、Cho/Cr、NAA/Cho比值,并记录病灶中心Lac和Lip峰是否出现。对各参数值进行统计学分析,明确其对鉴别三种疾病的诊断价值。结果病灶中心的Cho值胶质瘤㧐转移瘤㧐脑脓肿;Cho/Cr值胶质瘤㧐脑脓肿(P㩳0.05);NAA/Cho值脑脓肿㧐转移瘤㧐高级别胶质瘤;NAA及NAA/Cr在三组之间差异均无统计学意义。周围水肿区的NAA/Cr转移瘤组㧐脑脓肿组;Cho/Cr比值差异有显著统计学意义(P㩳0.001),胶质瘤组㧐脑脓肿组㧐转移瘤组,高级别胶质瘤组明显高于单发脑转移瘤组(P=0.000)且Cho/Cr临界值为1.5650时诊断为高级别胶质瘤的敏感度为73.3%,特异度为94.4%,ROC曲线下面积为0.921。周围水肿区NAA/Cho差异有显著统计学意义(P㩳0.001),转移瘤组高于胶质瘤组和脑脓肿组。高级别胶质瘤Lip峰出现率低于转移瘤和脑脓肿,转移瘤和脑脓肿组间比较差异无统计学意义。结论1HMRS可用于鉴别脑内单发环形强化病变,病灶中心的NAA/Cho和周围水肿区的Cho/Cr比值对高级别胶质瘤、单发脑转移瘤和脑脓肿的鉴别诊断具有重要意义。
[Abstract]:Objective to analyze the application of 3.0T proton magnetic resonance spectroscopy (1HMRS) in differentiating single ring enhancement lesions in brain. Methods PHILIPS 3.0T magnetic resonance scanner was used to scan 1HMRS in 65 patients with single ring-enhanced lesions in the brain during MRI enhancement. 30 cases of high-grade gliomas were confirmed by pathology or clinical diagnosis. There were 23 cases of single brain metastasis and 12 cases of brain abscess. The subpeak area of NAA,Cho and Cr in the center of the lesion and the surrounding edema area were measured, the NAA/Cr,Cho/Cr,NAA/Cho ratio was calculated, and the Lac and Lip peaks in the center of the lesion were recorded. The diagnostic value of each parameter value in differentiating the three diseases was determined by statistical analysis. Results the Cho value of the center of the lesion was glioma. Metastatic tumor? Brain abscess; Cho/Cr value glioma? Brain abscess (P0. 05); NAA/Cho? Metastatic tumor? There was no significant difference in NAA and NAA/Cr between the three groups. NAA/Cr metastasis in peripheral edema? There was significant difference in Cho/Cr ratio between brain abscess group and glioma group (P0. 001). Brain abscess group? The sensitivity and specificity of high grade glioma were 73.3 and 94.4 when the Cho/Cr threshold value was 1.5650 and the high grade glioma group was significantly higher than that of single brain metastases group (P0. 000). The area under the ROC curve is 0.921. The difference of NAA/Cho in peripheral edema was statistically significant (P0. 001). The NAA/Cho of metastatic tumor group was higher than that of glioma group and brain abscess group. The occurrence rate of Lip peak in high grade glioma was lower than that in metastatic tumor and brain abscess, and there was no significant difference between metastatic tumor and brain abscess group. Conclusion 1HMRS can be used to differentiate the single ring-enhanced lesions in the brain. The ratio of NAA/Cho in the center of the lesion to Cho/Cr in the peripheral edema area is of great significance for the differential diagnosis of high-grade gliomas, single brain metastases and brain abscesses.
【作者单位】：哈尔滨医科大学附属第四医院医学影像科;
【分类号】：R739.41;R445.2

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