【摘要】 目的探讨磁敏感加权成像(SWI)及波谱成像(MRS)在脑高、低级别星形细胞瘤鉴别诊断中的价值。资料与方法搜集2009年12月至2011年1月37例经手术病理证实的星形细胞瘤患者的MRI资料,所有患者术前均应用Siemens Verio 3.0 T超导磁共振仪行常规MRI平扫+增强、SWI和2D1H-MRS,并将各自结果同病理结果比较并统计分析,得出敏感度、特异度并同常规MRI比较。结果 (1)SWI序列中显示星形细胞瘤的出血率在高、低级别星形细胞瘤鉴别诊断中无显著性差异(P>0.05),而出血量在高、低级别星形细胞瘤鉴别诊断中有显著性差异(P<0.05)。(2)高、低级别星形细胞瘤瘤体代谢物胆碱(Cho)/N-乙酰天门冬氨酸(NAA)、Cho/肌酸(Cr)、NAA/Cr均有显著性差异(P<0.05)。(3)瘤体出血指数C值和Cho/NAA联合筛检,敏感度100%,特异度83.3%。结论 (1)同常规MRI比较,SWI能提高星形细胞瘤分级诊断的特异度,2D1H-MRS能提高星形细胞瘤分级诊断的准确度。(2)瘤体出血指数C值和Cho/NAA值联合筛检能提高星形细胞瘤分级诊断的敏感度。更多还原

【Abstract】 Objective To evaluate the magnetic resonance spectroscopy(MRS) and susceptibility weighted imaging(SWI) in differential diagnosis of high and low grade astrocytoma.Materials and Methods37 patients with astrocytomas confirmed by pathology received conventional MRI imaging,2D multivoxel 1H MRS spectroscopy(MRS) and susceptibility weighted imaging(SWI) examination on 3.0 T scanner(SIEMENS Verio 3.0 T) preoperatively from December 2009 to January 2011,and MRI findings were statistical analyzed and compared with Pathological results.The sensitivity and specificity of SWI and MRS were compared with that of routine MRI examination.Results(1)No significant statistical differences were found in ratio of hemorrhage between high and low grade astrocytoma with SWI,but significant statistical differences were found in blood volume.(2)There was significant difference in ratio of Cho/NAA,Cho/Cr and NAA /Cr in astrocytoma respectively(P<0.05).(3)Sensitivity and specificity for the C value and combination of Cho/NAA were 100% and 83.3%.Conclusion(1)SWI can increase the specificity and the metabolite ratios of MRS can increase accuracy in grading astrocytoma comparing to routine MRI imaging.(2)Combine the C value with the Cho/NAA can increase the sensitivity in grading astrocytoma.更多还原