【作者】 杨丽；

【导师】 贺丹；

【作者基本信息】 河北医科大学 ， 影像医学与核医学， 2009， 硕士

【摘要】 目的:探讨3.0T磁共振氢质子波谱(~1H-MRS)相对定量分析对颅内胶质瘤术前分级的临床应用价值。方法:应用GE 3.0T磁共振系统,对32例经病理证实的胶质瘤患者进行~1H-MRS检查,观察肿瘤实质区、瘤周水肿区及对侧正常区~1H-MRS谱线表现,定量分析各种代谢物(Cho/NAA、Cho/Cr、Lac或Lip/Cr、NAA/Cr、Cho /nCho)比值变化,并与病理结果相对照。另设11例为正常对照组。结果:胶质瘤肿瘤实质区和正常对照组脑组织的Cho/ NAA、Cho/Cr、NAA/Cr(2.05±0.70,2.10±1.04,0.84±0.44;0.61±0.10,0.87±0.13,1.43±0.14)及低级别和高级别胶质瘤肿瘤实质间的Cho/NAA、Cho/Cr、NAA/Cr、Cho/nCr、Lac(Lip)/Cr比值(1.74±0.61,1.58±0.63,0.96±0.57,1.04±0.81,1.58±0.10;3.35±0.89,2.62±1.45,0.78±0.31,2.14±1.77,2.61±2.75)存在显著性差异(P<0.05)。高、低级别胶质瘤瘤周水肿区Cho/Cr、NAA/Cr、Cho/NAA、Cho /nCho比值(2.21±0.49,1.12±0.23,2.09±0.82,1.47±1.13;1.43±0.32,0.82±0.45,1.22±0.19,1.23±0.36)亦存在显著性差异(P<0.05)。肿瘤实质区Cho/NAA、Cho/Cr、Cho/ nCho、Lac(Lip)/Cr比值与肿瘤的级别呈正相关性(r = 0.42,0.62,0.41,0.26),NAA/Cr与肿瘤级别呈负相关性(r = - 0.35);Cho/NAA的相关系数绝对值最大(r =0.62),与肿瘤级别相关性最高。结论:~1H-MRS可以为术前确定胶质瘤级别提供诊断依据,具有重要临床应用价值。更多还原

【Abstract】 Objective: To approach the clinical application value of corr-quantitative analysis with 3.0T magnetic resonance spectroscopy (~1H-MRS) in grading of cerebral glioma before operation.Methods: 32 patients with cerebral glioma confirmed by pathological results were performed with ~1H-MRS scanner , GE 3.0T magnetic resonance system were usd.The spectral line in the solid area of tumour、hydroncus area of ambi-tumour and normal-area of opposite side were observed with ~1H-MRS.The quantitative ratio change of various kinds metabolism(Cho/ NAA,Cho/Cr,Lac or Lip/Cr,NAA/Cr,Cho/nCho)were analyzed. The results of ~1H-MRS were compared with the results of patholoy.Another 11 examples were normal control.Results: There were significant difference in Cho/ NAA、Cho/Cr、NAA/Cr between solid area of glioma with normal-area of opposite side(2.05±0.70,2.10±1.04,0.84±0.44;0.61±0.10,0.87±0.13,1.43±0.14)and Cho/NAA、Cho/Cr、NAA/Cr、Cho/nCr、Lac(Lip)/Cr between solid area in the low grade glioma group with that in the high grade glioma group (1.74±0.61,1.58±0.63,0.96±0.57,1.04±0.81, 1.58±0.10;3.35±0.89,2.62±1.45,0.78±0. 31,2.14±1.77, 2.61±2.75) (P<0.05). There were significant difference in Cho/NAA、Cho/Cr、Cho/nCho(2.21±0.49,1.12±0.23,2.09±0.82,1.47±1.13;1.43±0.32,0.82±0.45,1.22±0.19,1.23±0.36) between hydroncus area of low grade glioma group with high grade glioma group(P<0.05).Cho/NAA、Cho/Cr、Cho/nCho、Lac (Lip)/Cr(r =0.42,0.62,0.41,0.26)of solid area of tumor was positive correlation with grade of tumor,and NAA/C(rr =- 0.35)was negative correction.The correlation coefficient of Cho/ NAA(r =0.62)was the maximum and had max dependability with grade of tumor.Conclusion: ~1H-MRS had very significance clinical application value in provideing diagnosis support for grading of cerebral glioma before operation.更多还原