【摘要】 目的 探讨常规MRI的影像学特征联合MRS成像在脑胶质瘤术前分级评估及预测术后复发中的价值。方法 分析68例经病理学证实及标准手术治疗的脑胶质瘤患者的临床资料。术前均进行MRI平扫增强检查及MRS检查。使用3D-Slicer软件测量肿瘤实质区体积及表面积、瘤周水肿体积、瘤周水肿体积与肿瘤实质区体积之比，同时测量肿瘤实质区及瘤周水肿区Cho/NAA、Cho/Cr的比值，比较术后不同病理级别与上述测量值的相关性。随访患者术后6～24个月内的复发情况。比较复发与未复发患者的肿瘤实质区体积、瘤周水肿体积、瘤周水肿体积与肿瘤实质区体积之比、肿瘤实质区Cho/NAA、Cho/Cr的比值。采用ROC曲线评估上述指标对预测脑胶质瘤术后复发的效能。结果 高级别胶质瘤组肿瘤实质区体积及表面积、瘤周水肿体积、瘤周水肿体积与肿瘤实质区体积之比、肿瘤实质区及瘤周水肿区Cho/NAA、Cho/Cr的比值高于低级别胶质瘤组，差异具有统计学意义（P<0.05）。与未复发患者比较，复发患者术前肿瘤实质区体积、瘤周水肿体积、瘤周水肿体积与肿瘤实质区体积之比、肿瘤实质区Cho/NAA、Cho/Cr的比值均较高，绘制ROC曲线分析上述指标对预测脑胶质瘤术后复发具有较高价值。结论 常规MRI的影像学特征联合MRS可评估脑胶质瘤的术前分级诊断，同时对预测术后复发具有价值。更多还原

【Abstract】 Objective To investigate the value of conventional MRI imaging features combined with MRS imaging in preoperative grading evaluation and prediction of postoperative recurrence of glioma. Methods The clinical data of 68 patients with brain glioma confirmed by pathology and treated by standard operation were analyzed. Preoperative MRI plain enhanced examination and MRS examination were performed.3D-Slicer software was used to measure the volume and surface area of tumor parenchyma, the volume of peritumoral edema, and the ratio of the volume of peritumoral edema to the volume of tumor parenchyma. Meanwhile, the ratio of Cho/NAA and Cho/Cr of tumor parenchyma and peritumoral edema were measured, and the correlation between the above measured values and different postoperative pathological grades was compared. Patients were followed up for recurrence 6 to 24 months after operation. The volume of tumor parenchyma, the volume of peritumoral edema, the ratio of the volume of peritumoral edema to the volume of tumor parenchyma, and the ratio of Cho/NAA and Cho/Cr in tumor parenchyma were compared between recurrent and non-recurring patients. ROC curve was used to evaluate the efficacy of the above indexes in predicting postoperative glioma recurrence. Results The volume and surface area of tumor parenchyma, the volume of peritumoral edema, the ratio of peritumoral edema volume to the volume of tumor parenchyma, and the ratio of Cho/NAA and Cho/Cr in the tumor parenchyma and peritumoral edema in the high-grade glioma group were higher than those in the low-grade glioma group. In the grade glioma group, the difference was statistically significant(P<0.05).Compared with non-relapsed patients, the preoperative tumor parenchymal volume, peritumoral edema volume, ratio of peritumoral edema volume to tumor parenchymal volume, and Cho/NAA and Cho/Cr ratios in tumor parenchyma were higher in patients with recurrence. ROC curve analysis of the above indicators has high value in predicting postoperative glioma recurrence. Conclusion The imaging features of conventional MRI combined with MRS can evaluate the preoperative grading diagnosis of glioma, and it is also valuable for predicting postoperative recurrence.更多还原