【摘要】 目的:探讨首次磁共振氢质子波谱(1H-MRS)对脑胶质瘤术后复发定性诊断的价值。方法:37例胶质瘤术后常规MRI对可疑肿瘤残留复发区域进行首次多体素1H-MRS扫描,之后均接受1次以上的常规MRI复查。结果:最终诊断肿瘤残留复发23例。以Cho/NAA≥1.5、Cho/Cr≥1.5、Cho/NAA≥2.0及联合常规MRI的MRS(c MRS)分别诊断肿瘤残留复发,相应的诊断灵敏度、特异度及准确性分别为(90.5%、81.3%及86.5%)、(90.5%、75.0%及83.3%)、(66.7%、93.8%及78.4%)和(91.3%、100.0%及94.6%),相应的ROC曲线下面积(AUC)分别为0.806、0.770、0.769及0.957,P值均<0.01;前3项中以Cho/NAA≥1.5最高,但3项AUC相互之间P值均﹥0.05;c MRS的AUC最大,且与前3项比较P值均<0.05,差异均有统计学意义。结论:首次1H-MRS对预测胶质瘤术后肿瘤复发具有一定的诊断价值,c MRS可提高其诊断准确性。更多还原

【Abstract】 Objective: To assess the value of qualitative diagnosis of recurrent brain glioma after resection with initial proton magnetic resonance spectroscopy(1 H-MRS). Methods: Conventional MRI and multi-voxel MRS were initially performed at the suspected recurrent tumor area in 37 patients with brain glioma after operation,followed by more than one re-examination with conventional MRI. Results: Twenty-three in the 37 patients were diagnosed as glioma residual or recurrent tumor. The sensitivity,specificity and accuracy by Cho/NAA≥1.5,Cho/Cr≥1.5,Cho/NAA≥2.0 and MRS combined with conventional MRI( c MRS) for diagnosis of glioma residual or recurrence were 90.5%,81.3% and 86.5%; 90.5%,75% and 83.3%; 66.7%,93.8% and 78.4%;91.3%,100% and 94.6%; respectively. The area under ROC curves( AUC) of the four parameters of Cho/NAA≥1.5,Cho/Cr≥1.5,Cho/NAA≥2.0 and c MRS was 0.806,0.770,0.769 and 0.957,respectively( all P<0.01). The parameter Cho/NAA≥1.5 was maximal,yet the AUC differences among the top three indexes were not all significant( all P>0.05). Maximal AUC of c MRS was seen in the four parameters and different from the top three indexes( all P<0.05). Conclusion: Initial1 H-MRS can be valuable in estimation of the recurrent brain glioma following resection,and c MRS may improve the diagnostic accuracy for this tumor.更多还原