中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
22期
47-50
,共4页
磁共振扩散加权成像%磁共振波谱分析%多体素%鉴别诊断
磁共振擴散加權成像%磁共振波譜分析%多體素%鑒彆診斷
자공진확산가권성상%자공진파보분석%다체소%감별진단
DWI%Magnetic resonance spectroscopy%Multi-voxel%Differential diagnosis
目的 探讨磁共振扩散加权成像(DWI)及多体素1H磁共振波谱分析在高级别胶质瘤与单发转移瘤中的鉴别诊断价值.方法 选取经手术病理或临床确诊的18例高级别脑胶质瘤及12例单发脑转移瘤患者.采用GE公司Signa EXCITE HD 3.0 T超导型MR扫描仪对所有患者行颅脑常规MRI扫描、DWI及二维多体素144 ms序列扫描.采用Functool软件包后处理,分别测定病变实质、病变周围及健侧相应区域的Cho/Cr、Cho/NAA、NAA/Cr比值的变化,并用SPSS 13.0软件对结果进行统计学分析.结果 高级别胶质瘤和脑转移瘤瘤体区Cho/NAA比较差异有统计学意义(P＜0.05)；Cho/Cr、NAA/Cr比较差异无统计学意义(P＞0.05)；瘤周水肿区Cho/Cr、Cho/NAA值分别比较差异有统计学意义(P＜0.05)；NAA/Cr比较差异无统计学意义(P＞0.05).高级别胶质瘤和脑转移瘤囊变坏死区平均ADC值分别为(1.22±0.31)×10-3 mm2/s、(1.35±0.23) ×10-3 mm2/s,两者比较差异无统计学意义(P＞0.05)；瘤周水肿区平均ADC值分别为(1.26±0.30)×10-3mm2/s、(1.81 ±0.12)×10-3mm2/s,两者比较差异有统计学意义(P＜0.05)；正常脑实质区平均ADC值为(0.89±0.56) ×10-3 mm2/s,与前两者分别比较差异有统计学意义(P＜0.05).结论 常规影像学常难以鉴别高级别胶质瘤与单发脑转移瘤,DWI及1H-MRS磁共振波谱分析在二者的鉴别诊断中有重要价值.
目的 探討磁共振擴散加權成像(DWI)及多體素1H磁共振波譜分析在高級彆膠質瘤與單髮轉移瘤中的鑒彆診斷價值.方法 選取經手術病理或臨床確診的18例高級彆腦膠質瘤及12例單髮腦轉移瘤患者.採用GE公司Signa EXCITE HD 3.0 T超導型MR掃描儀對所有患者行顱腦常規MRI掃描、DWI及二維多體素144 ms序列掃描.採用Functool軟件包後處理,分彆測定病變實質、病變週圍及健側相應區域的Cho/Cr、Cho/NAA、NAA/Cr比值的變化,併用SPSS 13.0軟件對結果進行統計學分析.結果 高級彆膠質瘤和腦轉移瘤瘤體區Cho/NAA比較差異有統計學意義(P＜0.05)；Cho/Cr、NAA/Cr比較差異無統計學意義(P＞0.05)；瘤週水腫區Cho/Cr、Cho/NAA值分彆比較差異有統計學意義(P＜0.05)；NAA/Cr比較差異無統計學意義(P＞0.05).高級彆膠質瘤和腦轉移瘤囊變壞死區平均ADC值分彆為(1.22±0.31)×10-3 mm2/s、(1.35±0.23) ×10-3 mm2/s,兩者比較差異無統計學意義(P＞0.05)；瘤週水腫區平均ADC值分彆為(1.26±0.30)×10-3mm2/s、(1.81 ±0.12)×10-3mm2/s,兩者比較差異有統計學意義(P＜0.05)；正常腦實質區平均ADC值為(0.89±0.56) ×10-3 mm2/s,與前兩者分彆比較差異有統計學意義(P＜0.05).結論 常規影像學常難以鑒彆高級彆膠質瘤與單髮腦轉移瘤,DWI及1H-MRS磁共振波譜分析在二者的鑒彆診斷中有重要價值.
목적 탐토자공진확산가권성상(DWI)급다체소1H자공진파보분석재고급별효질류여단발전이류중적감별진단개치.방법 선취경수술병리혹림상학진적18례고급별뇌효질류급12례단발뇌전이류환자.채용GE공사Signa EXCITE HD 3.0 T초도형MR소묘의대소유환자행로뇌상규MRI소묘、DWI급이유다체소144 ms서렬소묘.채용Functool연건포후처리,분별측정병변실질、병변주위급건측상응구역적Cho/Cr、Cho/NAA、NAA/Cr비치적변화,병용SPSS 13.0연건대결과진행통계학분석.결과 고급별효질류화뇌전이류류체구Cho/NAA비교차이유통계학의의(P＜0.05)；Cho/Cr、NAA/Cr비교차이무통계학의의(P＞0.05)；류주수종구Cho/Cr、Cho/NAA치분별비교차이유통계학의의(P＜0.05)；NAA/Cr비교차이무통계학의의(P＞0.05).고급별효질류화뇌전이류낭변배사구평균ADC치분별위(1.22±0.31)×10-3 mm2/s、(1.35±0.23) ×10-3 mm2/s,량자비교차이무통계학의의(P＞0.05)；류주수종구평균ADC치분별위(1.26±0.30)×10-3mm2/s、(1.81 ±0.12)×10-3mm2/s,량자비교차이유통계학의의(P＜0.05)；정상뇌실질구평균ADC치위(0.89±0.56) ×10-3 mm2/s,여전량자분별비교차이유통계학의의(P＜0.05).결론 상규영상학상난이감별고급별효질류여단발뇌전이류,DWI급1H-MRS자공진파보분석재이자적감별진단중유중요개치.
Objective To investigate the differential diagnostic value of DWI and multi-voxel 1H magnetic resonance spectroscopy for high-grade gliomas and solitary metastases of tumor.Methods Eighteen cases of high-grade gliomas and 12 cases of solitary metastases of tumor who confirmed by histopathologic findings or clinical follow-up were selected.All of the patients were performed with conventional MR scan,DWI and mutlti-voxel with 2-D mutlti-voxel PRESS 144 ms by GE Signa EXCITE HD 3.0 T super conduct MR unit.Functool software was used for post-processing of spectrum.The ratios of NAA/Cr,NAA/Cho,Cho/Cr were measured in the solid part of masses,circum of tumors and contralateral parenchyma respectively.The results were analyzed statistically by SPSS 13.0.Results In the solid part of masses,there was significant difference between high grade gliomas and metastases in the ratios of Cho/NAA (P ＜ 0.05),but there was no significant difference in the ratios of Cho/Cr,NAA/Cr; In peritumoral edema,there weresignificant differences in the ratios of Cho/Cr,Cho/NAA (P ＜ 0.05),but there was no significant difference in the ratios of NAA/Cr (P ＞ 0.05).The mean ADC values of the necrotic area of high-grade gliomas and metastatic brain tumor capsule were (1.22 ± 0.31) × 10-3 mm2/s and (1.35 ± 0.23) ×10-3 mm2/s,respectively,there was no significant difference (P ＞ 0.05) ; The mean ADC values of peritumoral edema were (1.26 ±0.30) × 10-3 mm2/s and (1.81 ±0.12) × 10-3 mm2/s,there was significant difference (P ＜ 0.05) ; The mean ADC value of normal brain parenchyma was (0.89 ± 0.56) × 10-3 mm2/s,which was statistically significant with the former two values (P ＜ 0.05).Conclusions Conventional imaging is often difficult to identify high-grade gliomas and solitary brain metastases,DWI and 1H-MRS magnetic resonance spectroscopy analysis has important value in the differential diagnosis of them.
