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目的运用多体素二维磁共振波谱法(~1H-MRS)分析脑胶质瘤周围区域~1H-MRS代谢物改变特点,评价~1H-MRS在脑胶质瘤术前的应用价值。方法收集经手术及病理证实的28例胶质瘤患者,所有患者在术前均行磁共振头颅常规检查和~1H-MRS检查。分别测量不同区域的N-乙酰天门冬氨酸(NAA)、肌酸(Cr)、胆碱(Cho)峰下面积,计算出NAA/Cr、Cho/Cr及NAA/Cho比值,并进行统计学分析。结果低/高级别胶质瘤肿瘤组织和对侧正常脑组织的NAA/Cr、Cho/Cr及NAA/Cho比值存在显著性差异;低/高级别胶质瘤肿瘤组织和远瘤周区域的NAA/Cr、Cho/Cr及NAA/Cho比值存在显著性差异;低级别胶质瘤远瘤周区域和对侧正常脑组织的NAA/Cho比值存在显著性差异,NAA/Cr、Cho/Cr比值不存在显著性差异;高级别胶质瘤远瘤周区域和对侧正常脑组织的Cho/Cr、NAA/Cho比值存在显著性差异,但NAA/Cr比值不存在显著性差异。结论多体素~1H-MRS可帮助临床医生在术前评价胶质瘤的浸润范围,并制定最佳的治疗方案。
Objective To evaluate the value of ~ 1H-MRS in the preoperative evaluation of brain gliomas by using multi-voxel two-dimensional magnetic resonance spectroscopy (~ 1H-MRS) to analyze the changes of ~ 1H-MRS metabolites in the peripheral region of gliomas. Methods Twenty-eight patients with gliomas confirmed by surgery and pathology were collected. All patients underwent magnetic resonance cranial routine examination and ~ 1H-MRS before operation. The areas under the NAA, Cr and Cho peaks in different regions were measured to calculate the ratio of NAA / Cr, Cho / Cr and NAA / Cho, analysis. Results There were significant differences in NAA / Cr, Cho / Cr and NAA / Cho ratios between low / high grade gliomas and contralateral normal brain tissues. NAA / Cr, Cho / Cr and NAA / Cho ratios were significantly different; NAA / Cho ratio of low grade gliomas in the peritumoral region and contralateral normal brain tissue was significantly different, NAA / Cr, Cho / Cr ratio There was significant difference between the two groups. Cho / Cr, NAA / Cho ratios of high grade gliomas in the peritumoral and contralateral normal brain tissues were significantly different, but NAA / Cr ratio had no significant difference. Conclusions Multi-voxel 1H-MRS can help clinicians evaluate the extent of glioma infiltration before surgery and develop the best treatment plan.