CAJ | 학술논문

目的：研究脑星形细胞瘤的3T MRI 3D多体素1H-MRS表现，通过分析 NAA，Cho，Cr，Lac and Lip，NAA/Cr, NAA/Cho, Cho/Cr比值变化，初步探讨脑星形细胞瘤1H-MRS术前分级诊断及与其病理级别相关性。方法收集浙江大学医学院附属第二医院和解放军第一一三医院经手术及病理证实的45例脑星形细胞瘤患者MRI资料，其中高级别脑星形细胞瘤组28例，低级别脑星形细胞瘤组17例。通过计算NAA/Cr，NAA/Cho, Cho/Cr等比值,分析脑星形细胞瘤波谱表现及高低级别组间差异。结果脑星形细胞瘤肿瘤组织与对照侧正常脑组织的NAA/Cho, Cho/Cr，NAA/Cr比值存在显著性差异(P＜0.05)； NAA/Cho、NAA/Cr比值在高低级别脑星形细胞瘤瘤周近区存在显著性差异(P＜0.05)；NAA/Cho、NAA/Cr比值在高级别脑星形细胞瘤和低级别脑星形细胞瘤的肿瘤组织有统计学差异(P<0.05)，肿瘤瘤体区NAA/Cho比值与肿瘤的级别呈负相关(r=-0.542，P<0.05)，NAA/Cr与肿瘤级别负相关(r=-0.502，P<0.05)，Cho/Cr比值与肿瘤的级别呈正相关(r=0.420，P<0.05)。结论3D多体素1H-MRS能够为术前肿瘤分级提供定量诊断依据，脑星形细胞瘤的病理级别与其代谢物比值有相关性，具有重要临床应用价值。
목적：연구뇌성형세포류적3T MRI 3D다체소1H-MRS표현，통과분석 NAA，Cho，Cr，Lac and Lip，NAA/Cr, NAA/Cho, Cho/Cr비치변화，초보탐토뇌성형세포류1H-MRS술전분급진단급여기병리급별상관성。방법수집절강대학의학원부속제이의원화해방군제일일삼의원경수술급병리증실적45례뇌성형세포류환자MRI자료，기중고급별뇌성형세포류조28례，저급별뇌성형세포류조17례。통과계산NAA/Cr，NAA/Cho, Cho/Cr등비치,분석뇌성형세포류파보표현급고저급별조간차이。결과뇌성형세포류종류조직여대조측정상뇌조직적NAA/Cho, Cho/Cr，NAA/Cr비치존재현저성차이(P＜0.05)； NAA/Cho、NAA/Cr비치재고저급별뇌성형세포류류주근구존재현저성차이(P＜0.05)；NAA/Cho、NAA/Cr비치재고급별뇌성형세포류화저급별뇌성형세포류적종류조직유통계학차이(P<0.05)，종류류체구NAA/Cho비치여종류적급별정부상관(r=-0.542，P<0.05)，NAA/Cr여종류급별부상관(r=-0.502，P<0.05)，Cho/Cr비치여종류적급별정정상관(r=0.420，P<0.05)。결론3D다체소1H-MRS능구위술전종류분급제공정량진단의거，뇌성형세포류적병리급별여기대사물비치유상관성，구유중요림상응용개치。
Objective This study was designed to approach the characteritics of astrocytoma 3D Mult-ivoxel1H-MRS and the correlation with grading diagnosis in preoperative grading by analyzing the contents changes of major metabolites such as NAA, Cho, Cr,Lac and Lip in astrocytoma1H-MRS, and jointly measuring ratio changes of NAA/Cr, NAA/Cho, Cho/Cr.Methods A total of 45 patients of brain astrocytoma which were confirmed by postoperative pathological results were gathered in the Second Affiliated hospital of Zhejiang University School of Medicine and PLA NO.113 hospital. Seventeen cases of low-grade astrocytoma (Ⅰ-Ⅱgrade),28 cases of high-grade astrocytoma (Ⅲ-Ⅳ grade). NAA/Cr, NAA/Cho, Cho/Cr, Lac/Cr ratio were computed.Results The mainly manifestation of brain astrocytoma1H-MRS was significant differences in NAA/Cho, Cho/Cr, NAA/Cr between solid area of astrocytoma and normal-area of opposite side(P<0.05); There were significant differences in NAA/Cho, NAA/Cr in solid area of astrocytoma between low-grade astrocytoma group and high-grade astrocytoma group(P<0.05), There were significant differences in NAA/Cho, NAA/Cr in peritumoral edema area between low-grade astrocytoma group and high-grade astrocytoma group(P<0.05), Cho/Cr (r=0.420)of solid area of tumor was of positive correlation with the grade of tumor, and NAA/Cr, NAA/Cho (r=-0.502,-0.542)was of negative correlation. Conclusion 3D Multi-voxel1H-MRS contributes to the clinical diagnosis of brain astrocytoma. The values of chemical composition ratio of tumor was correlation with the grade of tumor, which provide quantify diagnosis basis for grading of brain astrocytoma before surgery, to sum up, has very significance clinical application value.