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目的:探讨多体素(multi-voxel)1H磁共振波谱(1H magnetic resonance spectroscopy,1H-MRS)对胶质瘤诊断及分级的应用价值。方法:回顾分析武进人民医院2005年8月～2008年12月1H磁共振波谱检查并经病理证实的48例胶质瘤的临床资料,根据胶质瘤恶性程度不同分为低恶性组21例(包括星形细胞瘤Ⅰ级和Ⅱ级,室管膜瘤、少突胶质细胞瘤等),及高度恶性组27例(包括星形细胞瘤Ⅲ级和Ⅳ级、多形性胶质母细胞瘤、间变性室管膜瘤、髓母细胞瘤)。观察氮乙酰门冬氨酸(N-acetylas-partate,NAA)、胆碱(choline,Cho)、肌酸(creatine,Cr)、肌醇(inositol,Ins)的共振峰及相关比值,以对侧对应的正常脑组织的相应值作对照分析。结果:与病变对侧相对应的正常脑组织相比,低度及高度恶性胶质瘤均表现为NAA含量下降,Cho含量增高,Cr总量变化不大,Ins含量轻度下降;NAA/Cr值降低,Cho/Cr值升高,NAA/Cho值显著降低,且低度恶性胶质瘤中的NAA均显著高于、Cho显著低于高度恶性胶质瘤,NAA/Cho值在高度恶性胶质瘤中低于低度恶性胶质瘤。结论:1H-MRS对胶质瘤的诊断和明确分级具有重要的临床价值。
Objective: To investigate the value of 1H-MRS (1H-MRS) in diagnosis and classification of gliomas. Methods: Retrospective analysis of Wujin People’s Hospital from August 2005 to December 2008 1H magnetic resonance spectroscopy and pathology confirmed 48 cases of glioma clinical data, according to the degree of malignancy of glioma divided into 21 cases of low-grade group ( Including astrocytoma grade I and II, ependymoma, oligodendroglioma, etc.), and 27 cases of high grade malignancy (including grade III and IV astrocytoma, glioblastoma multiforme Neoplasms, mesenchymal transitional medulloblastoma, medulloblastoma). The resonance peaks and relative ratios of N-acetylas-partate (NAA), choline (Cho), creatine (Cr) and inositol (Ins) The corresponding normal brain tissue corresponding values for controlled analysis. Results: Compared with the normal brain tissue on the opposite side of the lesion, both low and high grade gliomas showed a decrease in NAA content, a high Cho content, a slight change in Cr content, and a slight decrease in Ins content. NAA / Cr Value of Cho / Cr increased, NAA / Cho decreased significantly, and NAA in low grade glioma was significantly higher than that in Cho, which was significantly lower than that in high grade gliomas Tumors in the low-grade glioblastoma. Conclusion: 1H-MRS has important clinical value in the diagnosis and classification of gliomas.