CAJ | 학술논문

目的：探讨鼻咽癌多体素氢质子磁共振波谱的表现及其临床价值。方法选择2010年2月~2013年2月在浙江大学医学院附属第二医院收治的鼻咽癌患者110例(观察组)，另选择同期来该：行健康体检的100例健康体检者(正常组)，利用1.5T symphony超导型磁共振成像机行头颈部波谱扫描，记录并分析结果。将观察组的图像观察兴趣区分为瘤体区、瘤周区、对照区，观察其波谱图的变化状态。同时记录N-乙酰天门冬氨酸(NAA)、胆碱(Cho)和肌酸(Cr)等代谢物波峰值。计算三区域的NAA/Cho、NAA/Cr及Cho/Cr等比值。结果T2WI及多体素氢质子磁共振波谱显示：正常组颌面部肌肉在δ1.0~1.4处可见宽大的脂质峰；观察组在δ3.0~3.6可见宽大的脂质峰，体素大小为1.6~11.5 cm3，平均(4.9±0.4)cm3。观察组对照区NAA/Cho、NAA/Cr均明显高于瘤体区、瘤周区，差异均有统计学意义(P<0.05)，Cho/Cr明显低于瘤体区、瘤周区，差异有统计学意义(P<0.05)；三个区域NAA/Cho、NAA/Cr、Cho/Cr比较差异有统计学意义(P<0.05)。结论 Cho/Cr比值可以作为鼻咽癌诊断的标准之一。
목적：탐토비인암다체소경질자자공진파보적표현급기림상개치。방법선택2010년2월~2013년2월재절강대학의학원부속제이의원수치적비인암환자110례(관찰조)，령선택동기래해：행건강체검적100례건강체검자(정상조)，이용1.5T symphony초도형자공진성상궤행두경부파보소묘，기록병분석결과。장관찰조적도상관찰흥취구분위류체구、류주구、대조구，관찰기파보도적변화상태。동시기록N-을선천문동안산(NAA)、담감(Cho)화기산(Cr)등대사물파봉치。계산삼구역적NAA/Cho、NAA/Cr급Cho/Cr등비치。결과T2WI급다체소경질자자공진파보현시：정상조합면부기육재δ1.0~1.4처가견관대적지질봉；관찰조재δ3.0~3.6가견관대적지질봉，체소대소위1.6~11.5 cm3，평균(4.9±0.4)cm3。관찰조대조구NAA/Cho、NAA/Cr균명현고우류체구、류주구，차이균유통계학의의(P<0.05)，Cho/Cr명현저우류체구、류주구，차이유통계학의의(P<0.05)；삼개구역NAA/Cho、NAA/Cr、Cho/Cr비교차이유통계학의의(P<0.05)。결론 Cho/Cr비치가이작위비인암진단적표준지일。
Objective To explore the expression and its clinical value of 1H-MRS for nasopharyngeal carcinoma. Methods From February 2010 to February 2013, in the Second Hospital Affiliated to Zhejiang University School of Medicine, 110 patients with nasopharyngeal carcinoma were chosen as the observation group, at the same time, 100 healthy people with physical examination in this hospital were chosen as normal group, 1.5T symphony type supercon-ducting magnetic resonance imaging on the research object line of head and neck spectrum scanning was used, the re-salts were recorded and analyzed. In the observation group, interest in the image observation area was divided into tu-mors area, week of tumor area and control area for three different areas, change of the spectrum on the spectrogram was observed. The corresponding PPM position for N-acetyl aspartic acid (NAA), choline (Cho) and creatine (Cr), and other metabolites crest value were recorded, and input into SAS statistical software package. Tumor entity, tumor weeks re-spectively calculated area and control area NAA/Cho, NAA/Cr, Cho/Cr ratio, etc were counted. Results T2WI 1H-MRS showed: in normal group the maxillofacial muscles at δ1.0-1.4 was wide lipid peak; in observation group that at δ3.0-3.6 with wide was lipid peak, voxel size was 1.6-11.5 cm3, with average of (4.9±0.4) cm3. In observation group, the control area NAA/Cho, NAA/Cr were significantly higher than that of tumors, tumor weeks district, the difference was statistically significant (P<0.05), Cho/Cr was significantly lower than that of the week of tumors, tumor area, the dif-ference was statistically significant (P< 0.05). Three regional comparison between groups, the differences of NAA/Cho, NAA/Cr, Cho/Cr were statistically significant (P<0.05). Conclusion Cho/Cr ratio can be used as one of the standard for diagnosis of nasopharyngeal carcinoma.