中华神经外科杂志
中華神經外科雜誌
중화신경외과잡지
Chinese Journal of Neurosurgery
2013年
4期
383-386
,共4页
庞浩鹏%吴光耀%刘国兵%杨时骐%高树波
龐浩鵬%吳光耀%劉國兵%楊時騏%高樹波
방호붕%오광요%류국병%양시기%고수파
髓母细胞瘤%质子磁共振波谱%扩散加权成像%ADC值%牛磺酸峰
髓母細胞瘤%質子磁共振波譜%擴散加權成像%ADC值%牛磺痠峰
수모세포류%질자자공진파보%확산가권성상%ADC치%우광산봉
Medulloblastoma%Proton nuclear magnetic resonance%Diffusion weighted imaging%ADC value%Tau peak
目的 分析髓母细胞瘤3.0T磁共振质子波谱(1H MRS)和扩散加权成像(DWI)特征,结合文献探讨其生物学意义及其鉴别诊断价值.方法 回顾性分析17例经病理证实髓母细胞瘤术前应用点分辨选择波谱单体素1H MRS和DWI中表观扩散系数(ADC)特征,比较病例组与对照组(年龄、性别匹配正常人相应部位波谱)代谢物间比值和ADC值差异,对照组为自身对照,取镜像对称正常部位感兴趣区(ROI),检验水准α=0.05,P＜0.05为差异有统计学意义.结果 17例髓母细胞瘤1H MRS均显示NAA和Cr峰显著降低,Cho峰显著升高,mI峰出现；其中11例3.42 ppm处见小Tau峰(占64.7％),5例0.9～1.3 ppm处见Lip峰,3例1.33 ppm处见倒置Lac峰(1例可见Lip、Lac双峰).与对照组比较:NAA/Cho、NAA/Cr显著降低,Cho/Cr显著升高(P＜0.001).17例在DWI上均呈相对高信号,ADC值降低(P＜0.001).结论 髓母细胞瘤1 H MRS和DWI有特征性表现,藉此可提高其定性诊断准确率；特征性Tau峰和ADC值的定量分析,有助于髓母细胞瘤生物学行为、预后评估及治疗方案选择.
目的 分析髓母細胞瘤3.0T磁共振質子波譜(1H MRS)和擴散加權成像(DWI)特徵,結閤文獻探討其生物學意義及其鑒彆診斷價值.方法 迴顧性分析17例經病理證實髓母細胞瘤術前應用點分辨選擇波譜單體素1H MRS和DWI中錶觀擴散繫數(ADC)特徵,比較病例組與對照組(年齡、性彆匹配正常人相應部位波譜)代謝物間比值和ADC值差異,對照組為自身對照,取鏡像對稱正常部位感興趣區(ROI),檢驗水準α=0.05,P＜0.05為差異有統計學意義.結果 17例髓母細胞瘤1H MRS均顯示NAA和Cr峰顯著降低,Cho峰顯著升高,mI峰齣現；其中11例3.42 ppm處見小Tau峰(佔64.7％),5例0.9～1.3 ppm處見Lip峰,3例1.33 ppm處見倒置Lac峰(1例可見Lip、Lac雙峰).與對照組比較:NAA/Cho、NAA/Cr顯著降低,Cho/Cr顯著升高(P＜0.001).17例在DWI上均呈相對高信號,ADC值降低(P＜0.001).結論 髓母細胞瘤1 H MRS和DWI有特徵性錶現,藉此可提高其定性診斷準確率；特徵性Tau峰和ADC值的定量分析,有助于髓母細胞瘤生物學行為、預後評估及治療方案選擇.
목적 분석수모세포류3.0T자공진질자파보(1H MRS)화확산가권성상(DWI)특정,결합문헌탐토기생물학의의급기감별진단개치.방법 회고성분석17례경병리증실수모세포류술전응용점분변선택파보단체소1H MRS화DWI중표관확산계수(ADC)특정,비교병례조여대조조(년령、성별필배정상인상응부위파보)대사물간비치화ADC치차이,대조조위자신대조,취경상대칭정상부위감흥취구(ROI),검험수준α=0.05,P＜0.05위차이유통계학의의.결과 17례수모세포류1H MRS균현시NAA화Cr봉현저강저,Cho봉현저승고,mI봉출현；기중11례3.42 ppm처견소Tau봉(점64.7％),5례0.9～1.3 ppm처견Lip봉,3례1.33 ppm처견도치Lac봉(1례가견Lip、Lac쌍봉).여대조조비교:NAA/Cho、NAA/Cr현저강저,Cho/Cr현저승고(P＜0.001).17례재DWI상균정상대고신호,ADC치강저(P＜0.001).결론 수모세포류1 H MRS화DWI유특정성표현,자차가제고기정성진단준학솔；특정성Tau봉화ADC치적정량분석,유조우수모세포류생물학행위、예후평고급치료방안선택.
Objective To analyze the characteristics of 1H MRS and DWI in medulloblastoma (MB) with 3.0 T MRI,and to explore the relationship between the findings and its histopathology.Methods 17 MBs,confirmed by pathology,were retrospectively analyzed on preoperative 1H MRS and DWI.The differences were compared between the lesion group and the control group (t-test,P ＜ 0.05).The metabolites were semiquantitatively analyzed by independent samples test.Quantitative analysis of the ADC value in the solid neoplasm was performed using the paired samples test,which localized the mirror symmetry position of MB as comparison.Results In the 17 MBs,NAA and Cr peaks decreased noticeably,Cho peak increased noticeably,while the mI peak presented.11 MBs showed low Tau peak at 3.42 ppm (parts per million).5 MBs showed Lip peak at 0.9 ～1.3 ppm.3 MBs showed negative Lac peak at 1.33 ppm (one case showed double peaks of Lip and Lac).Compared with the control group,the ratios of NAA/Cho and NAA/Cr significantly decreased while the ratio of Cho/Cr significantly increased.In all MBs,DWI presented with higher signal intensity and ADC value decreased significantly(P ＜0.001).Conclusions 1H MRS and DWI of MB have significant evidence for improving the diagnostic rate.Quantitative estimation of Tau peak and the ADC value may contribute to assessing the biological behavior,the prognosis and the choice of therapeutic schedule for MB.
