Domingo Z, Rowe G, Blamire A M, Cadoux-Hudson T A
MRC Magnetic Spectroscopy Unit, John Radcliffe Hospital, Oxford, UK.
Br J Neurosurg. 1998 Oct;12(5):414-8. doi: 10.1080/02688699844600.
Oedema surrounding meningiomas is well known, but its pathogenesis remains obscure. Perfusion and metabolism in this peritumoural parenchyma were studied preoperatively in eight patients using magnetic resonance imaging, dynamic perfusion scanning and proton spectroscopy. Relative cerebral blood volumes (CBV) and metabolite ratios were calculated for the tumour and peritumoural brain. All meningiomas showed gadolinium enhancement, high choline (Ch), low creatine (Cr) and low N-acetyl aspartate (NAA) [Ch: (Ch + Cr) 0.67, SD 0.13, NAA: (Ch + Cr) 0.18, SD 0.15]. Lactate was present in four tumours [lactate: (Ch + Cr) 0.32, SD 0.27]. Extremely low gadolinium passage and low CBV were seen in the 2 cm peritumoural region, with elevated lactate [lactate: (Ch + Cr) 0.26, SD 0.18]. Four centimetres from tumour margin the CBV was still reduced (65, SD 20% with less lactate [lactate: (Ch + Cr) 0.12, SD 0.01]. Relative CBV is reduced around meningiomas and is associated with lactate, suggesting that oligaemia and altered metabolism may be part of the pathology in peritumoural oedema. Such changes may be important in determining functional recovery after surgery.
脑膜瘤周围水肿广为人知，但其发病机制仍不清楚。术前使用磁共振成像、动态灌注扫描和质子波谱对8例患者肿瘤周围实质的灌注和代谢进行了研究。计算肿瘤和肿瘤周围脑组织的相对脑血容量（CBV）和代谢物比率。所有脑膜瘤均表现为钆增强、高胆碱（Ch）、低肌酸（Cr）和低N-乙酰天门冬氨酸（NAA）[Ch：（Ch+Cr）0.67，标准差0.13，NAA：（Ch+Cr）0.18，标准差0.15]。4个肿瘤中存在乳酸盐[乳酸盐：（Ch+Cr）0.32，标准差0.27]。在肿瘤周围2厘米区域可见极低的钆通过量和低CBV，同时乳酸盐升高[乳酸盐：（Ch+Cr）0.26，标准差0.18]。距肿瘤边缘4厘米处CBV仍降低（65，标准差20%），乳酸盐减少[乳酸盐：（Ch+Cr）0.12，标准差0.01]。脑膜瘤周围相对CBV降低并与乳酸盐相关，提示低血供和代谢改变可能是肿瘤周围水肿病理改变的一部分。这些变化在确定手术后的功能恢复方面可能很重要。
