【摘要】 目的应用磁共振氢质子波谱(1H-MRS)分析检测脑胶质瘤瘤周区Cho/Cr值,评估其与脑胶质瘤病理分级的相关性及理想阈值。方法经手术病理证实的脑胶质瘤76例,均于术前应用GE 1.5 T磁共振设备进行常规MRI平扫、增强及1H-MRS检查,76例胶质瘤中,低级别(Ⅰ~Ⅱ级)胶质瘤36例,其中I级4例,Ⅱ级32例,高级别(Ⅲ ~ Ⅳ级)胶质瘤40例,其中Ⅲ级25例,Ⅳ级15例。应用AW 4.4工作站,通过波谱软件分析包获得波谱分析数据,检测肿瘤瘤周区最大Cho/Cr值。采用t检验比较分析高、低级别胶质瘤瘤周区最大Cho/Cr值,绘制ROC曲线确定鉴别高、低级别胶质瘤瘤周区Cho/Cr值的理想阈值,检验水准ɑ为0.05。结果低级别(Ⅰ~Ⅱ级)胶质瘤瘤周区Cho/Cr值为1.57 ± 0.74(CI± Se),高级别(Ⅲ ~ Ⅳ级)胶质瘤瘤周区Cho/Cr值为2.42 ± 1.16。统计学分析显示,低级别(Ⅰ~Ⅱ级)与高级别(Ⅲ ~ Ⅳ级)胶质瘤瘤周区Cho/Cr值差异有统计学意义(P= 0.0003)。经Spearman法相关性分析,胶质瘤的病理级别与胶质瘤瘤周区Cho/Cr值呈正相关(r= 0.44),其ROC曲线曲线下面积为0.72,以胶质瘤瘤周区Cho/Cr值2.15作为理想阈值时,其灵敏度为58.97﹪,特异度为81.08﹪。结论脑胶质瘤瘤周区最大Cho/Cr值与其病理分级呈正相关,通过检测和计算瘤周区Cho/Cr最大值,能帮助评估胶质瘤的病理级别。更多还原

【Abstract】 Objective To evaluate the relationship between the maximum Cho/Cr values of surrounding area of tumor and the grade in gliomas. Methods 76 subjects with gliomas[36 cases of low-grade(grade Ⅰ~ Ⅱ), 40 cases of high-grade(grade Ⅲ ~ Ⅳ), of which 4 cases grade I, 32 cases grade Ⅱ, 25 cases grade Ⅲ and 15 cases grade Ⅳ] underwent conventional MRI plane scan, contrast enhanced MRI scan and 1H-MRS. Spectrum analysis was performed with dedicated dedicated software. The maximum Cho/Cr values in areas surrounding tumors were calculated. This values in subjects with high-grade and low-grade tumors were compared with t-test assuming a significant level of 0.05﹪. Results The maximum Cho/Cr values in the surrounding area of gliomas of low-grade and high-grade gliomas were 1.57 ± 0.74 and 2.42 ± 1.16 respectively, there is a significant difference between that of high and low grade of gliomas(P = 0.0003). Cho/Cr value change of surrounding area of tumor was positively correlated with the histological grade. ROC analysis showed an AUC of 0.72, with 2.15 selected as the threshold, the sensitivity and specificity were 58.97﹪ and 81.08﹪. Conclusion The maximum Cho/Cr values of the surrounding area of tumor can be used as an index in staging of gliomas.更多还原