【摘要】 目的通过分析原发颅内弥漫大B细胞淋巴瘤(DLBCL)术前1H-MRS与术后病理的相关性,评价MR波谱在DLBCL预后评估中的应用价值。方法回顾性分析经手术病理证实的11例原发颅内DLBCL患者的MRI、1H-MRS及病理资料。分析肿瘤的部位、形态、信号等特点;定量测量肿瘤实质区和对照脑实质区各代谢物(Cho、Cr、NAA)波峰下面积和峰高比值(NAA/Cr、Cho/Cr、Cho/NAA),采用配对t检验比较两组间差异;对肿瘤实质区的Cho峰下面积与免疫组化Ki-67表达水平进行Spearman相关性分析。结果 11例原发颅内DLBCL均表现为肿瘤实质区Cho峰升高,NAA峰及Cr峰减低,并可见Lip峰,Cho/Cr及Cho/NAA比值升高,NAA/Cr比值减低。统计分析表明,除Cr外,肿瘤实质区与对照脑实质区各代谢物及比值的差异均具有统计学意义(P<0.05)。Spearman相关分析显示,肿瘤实质区Cho峰下面积与Ki-67表达水平呈正相关关系(rs=0.627,P=0.039)。结论 1H-MRS对原发颅内DLBCL的术前诊断具有重要作用,在肿瘤预后评估中亦有较大应用价值。更多还原

【Abstract】 Objective To evaluate the application value of 1H-MRS in assessing prognosis of primary intracranial diffuse large B-cell lymphoma(DLBCL) by comparing 1H-MRS with pathology result. Methods MRI features, 1H-MRS and pathology results of 11 intracranial DLBCL were retrospectively analyzed. Tumor location, appearance and signal were analyzed. Cho, Cr, NAA, NAA/Cr, Cho/Cr, Cho/NAA values of the tumor solid part and contralateral brain parenchyma were measured. Paired sample T test was used to compare the tumors and control brain parenchyma. Correlation of Cho and Ki-67 was analyzed with Spearman analysis. Results All 11 cases showed raised Cho, Cho/Cr and Cho/NAA, and decreased NAA, Cr and NAA/Cr. The statistical analysis demonstrated that all except Cr had statistical significance(P<0.05) between tumor solid region and compared normal brain. Spearman correlation analysis showed positive correlation between Cho and the expression level of Ki-67(rs=0.627, P=0.039). Conclusion 1HMRS has played an important role in preoperative diagnosis of intracranial DLBCL, it also could be used as an useful tool for assessing prognosis.更多还原