【摘要】 目的:利用高分辨魔角旋转质子磁共振波谱(HRMAS-1H MRS)检测脑肿瘤手术标本,分析胶质瘤及脑膜瘤水溶性代谢物特征,探讨HRMAS-1H MRS临床应用价值。方法:30例病理证实脑肿瘤,6例Ⅰ~Ⅱ级星形细胞瘤,7例间变(Ⅲ级)星形细胞瘤,10例胶质母细胞瘤(Ⅳ级)和7例脑膜瘤。Varian公司600MHz谱仪上Nano探头采集HRMAS-1H MRS,jMRUI3.2版软件处理,总结代谢物出现几率,比较代谢物与Cr比值。结果:HRMAS-1H MRS能分辨NAA、PCr/Cr、GPC+PCho+Cho、Glu/Gln、Gly、Tau、Ala、Lac、mI等脑内多种代谢物。所有样本均显示Lac峰,6例样本在3.72ppm或3.90ppm处显示一组不知名的单峰。6例Ⅰ~Ⅱ级星形细胞瘤Cho/Cr2.42±1.01,与胶质母细胞瘤组比较P=0.003;7例间变性星形细胞瘤Cho/Cr3.48±0.59,与胶质母细胞瘤组比较P=0.01;10例胶质母细胞瘤Cho/Cr变化范围大,从0.9~11.3,平均值5.40±1.23。从Ⅰ~Ⅱ级星形细胞瘤到胶质母细胞瘤Gly、Tau、mI、Ala出现几率增加,Ala/Cr、Tau/Cr和Gly/Cr有升高趋势;胶质瘤Ala/Cr0.31±0.13。脑膜瘤Ala峰和Cho峰较高,Cr峰较胶质瘤下降。4/7例无NAA峰,3/7例有较低NAA峰。Cho/Cr3.56±1.01;Ala/Cr0.53±0.28,与胶质瘤比较P=0.006。结论:HRMAS-1H MRS能进一步显示波谱细节,分辨活体波谱中Cho峰下代谢物,显示胶质瘤良恶性程度。随着恶性程度增加,Cho、mI、Ala、Tau、Gly增加。HRMAS-1H MRS是唯一能得到病理标本各项同性波谱的方法。更多还原

【Abstract】 Objective:To detect specimens of brain tumors with HRMAS-1H MRS,to analyze their soluble metabolites,and discuss clinical value about the technique.Methods:There were 30 cases of brain tumor confirmed by pathology,including Ⅰ~Ⅱ graded astrocytomas (n=6),Ⅲ graded astrocytomas (n=7),Ⅳ glioblastomas (n=10),meningiomas (n=7).All data were got with Varian 600MHz spectrometer and analyzed on MRUI software.Results:HRMAS-1H MRS could resolve lots of metabolites,such as NAA,PCr /Cr,GPC+PCho+Cho,Glu/Gln,Gly,Tau,Ala,Lac,mI,etc.All samples had Lac peak.6 samples showed unknown peak at 3.72ppm or 3.90ppm.The ratio of Cho/Cr to Ⅰ~Ⅱ astrocytomas was 2.42±1.01,compared with glioblastomas (5.40±1.23),P=0.003.The ratio of Cho/Cr to astrocytomas was 3.48±0.59,compared with glioblastomas,P=0.01.The showed opportunities of Gly, Tau, mI and Ala were improved with the upgrading of astrocytoma.The values of Ala/Cr,Tau/Cr and Gly/Cr were elevated.The ratio of Ala/Cr to gliomas was 0.31±0.13.3.In meningiomas,4 cases showed no NAA,3 cases presented NAA.The ratio of Ala/Cr was 0.53±0.28,compared with gliomas,P=0.006.Conclusions:HRMAS-1H MRS can show more detail spectrum,resolve ingredients of the Cho compound and graded degree of gliomas.With the malignancy of gliomas raising,Cho,mI,Ala,Tau and Gly may elevate.HRMAS-1H MRS is the only method which is able to acquire isotropic spectroscopy of solid samples.更多还原