CAJ | 학술논문

目的探讨活体31P MR波谱(31P MRS)在骨恶性肿瘤与炎症鉴别中的价值.方法对32名健康志愿者、20例恶性骨肿瘤、22例骨及软组织炎症患者分别行常规X线、MRI与31P MRS 检查,测定波谱中各代谢产物的峰下面积,计算各代谢产物间的比值,并根据无机磷(Pi)相对于磷酸肌酸(PCr)的化学位移测定细胞内pH值.统计学采用单因素方差分析.结果 31P MRS检测发现恶性骨肿瘤组磷酸单酯(PME)/β-三磷酸腺苷(ATP)值(1.24±0.37)明显高于对照组和炎症组(P值均＜0.01);炎症组磷酸二酯(PDE)/β-ATP(2.21±0.37)、Pi/β-ATP(1.46±0.43)明显高于对照组和恶性肿瘤组(P值均＜0.05),但PME/β-ATP(0.19±0.10)值不高;对照组低能磷酸盐(LEP)/总31P代谢物(T31P)(0.10±0.02)、PCr/T31p(0.45±0.03)、ATP/T31P(0.45±0.03)与恶性骨肿瘤和炎症组之间差异有统计学意义(P值均＜0.01);恶性肿瘤组细胞内pH值为7.45±0.16,明显高于正常对照组(7.05±0.06)和炎症组(7.20±0.13)(P值均＜0.01).结论组织中PME和细胞内pH值的升高对恶性骨肿瘤的诊断有重要意义.MRS技术与常规X线、MRI相结合,有助于临床对恶性骨肿瘤与炎症的鉴别.
목적 탐토활체31P MR파보(31P MRS)재골악성종류여염증감별중적개치.방법 대32명건강지원자、20례악성골종류、22례골급연조직염증환자분별행상규X선、MRI여31P MRS 검사,측정파보중각대사산물적봉하면적,계산각대사산물간적비치,병근거무궤린(Pi)상대우린산기산(PCr)적화학위이측정세포내pH치.통계학채용단인소방차분석.결과 31P MRS검측발현악성골종류조린산단지(PME)/β-삼린산선감(ATP)치(1.24±0.37)명현고우대조조화염증조(P치균＜0.01);염증조린산이지(PDE)/β-ATP(2.21±0.37)、Pi/β-ATP(1.46±0.43)명현고우대조조화악성종류조(P치균＜0.05),단PME/β-ATP(0.19±0.10)치불고;대조조저능린산염(LEP)/총31P대사물(T31P)(0.10±0.02)、PCr/T31p(0.45±0.03)、ATP/T31P(0.45±0.03)여악성골종류화염증조지간차이유통계학의의(P치균＜0.01);악성종류조세포내pH치위7.45±0.16,명현고우정상대조조(7.05±0.06)화염증조(7.20±0.13)(P치균＜0.01).결론 조직중PME화세포내pH치적승고대악성골종류적진단유중요의의.MRS기술여상규X선、MRI상결합,유조우림상대악성골종류여염증적감별.
Objective To explore the value of 31P magnetic resonance spectroscopy(31P MRS)for differential diagnosis of bone malignancy and inflammation.Methods Radiography.MRI and 31P MRs were performed on 20 bone malignancy patients,22 bone and soft-tissue inflarnmation patients and 32 healthy voluntecrs.The spectra were analyzed by measuring the areas under the peaks of various metabolites,and by calculating the pH from the Pi shift relative to PCr.The data were analyzed by one-way analysis of vailance (ANOVA).Results Analysis of the 31P MRS data suggested differences among the bone malignancy,the inflammation and the healthy group.The mean of PME/β-ATP ratio(1.24±0.37)in malignancy group increased significantly(P＜0.01).The mean of PDE/β-ATP(2.21.±0.37),Pi/β-ATP(1.46±0.43)in inflammation group was higher than that of the other two groups(P＜0.05),but the ratio of PME/β-ATP (0.19±0.10)wag not increasing.The LEP/T31P(0.10±0.02),PCr/T31P(0.45±0.03)and ATP/T31P (0.45±0.03)ratios in control group were significantly difierent from the two others(P＜0.01).The mean of intracellular pH in malignancy group was 7.45±0.16,higher than that in control group(7.05±0.06),and in inflaruination group(7.20±0.13)(P＜0.01).Conclusions The significant increase of PME and intraeellular pH is of great value in diagnosis of bone malignancy.Combined conventional radiography and MRI.31PMRs would be a simple,no-.invasive and effective diagnostic method.