Zakrzewski K, Kreisel J, Polis L, Nowosławska E, Liberski P P, Biegański T
Kliniki Neurochirurgii Instytutu Centrum Zdrowia Matki Polki w Łodzi.
Neurol Neurochir Pol. 2001;35 Suppl 5:19-25.
We report here on a correlation between proton magnetic resonance spectroscopy (MRS) spectra obtained in children with posterior fossa tumors and tumor histology and grading. Twenty-six children (age 1-16) were investigated before surgery by using single-voxel proton MRS. All examination were performed on a 1.5 T MR scanner by using single-voxel (8 cm3) with PRESS sequence (TR 1600 ms, TE 270 ms, NEX 256). Spectra of N-acetylaspartate (NAA), choline containing compounds (Cho), creatine and phosphocreatine (Cr) and lactate (Lac) were evaluated. Absolute concentrations of the metabolites were measured and their ratios were calculated. Correlation between these and tumor histology and grading were then determined. Concentration of Cho and Lac, and Cho/NAA ratio were the major statistically significant parameters for discrimination between benign (WHO grade I and II) and malignant tumors (WHO grade III and IV), in particular between pilocytic astrocytomas and medulloblastomas. Discrimination between individual histological types within malignant and benign tumor groups was not possible. Proton MRS of pediatric posterior fossa tumors seems to be helpful in prediction of tumor grading and histology. Specific character of the examination requires establishing of the individual standards for every MR scanner.
我们在此报告后颅窝肿瘤患儿的质子磁共振波谱（MRS）谱与肿瘤组织学及分级之间的相关性。对26名年龄在1至16岁的儿童在手术前进行了单体素质子MRS检查。所有检查均在1.5T MR扫描仪上使用具有PRESS序列（TR 1600ms，TE 270ms，NEX 256）的单体积（8cm³）进行。评估了N-乙酰天门冬氨酸（NAA）、含胆碱化合物（Cho）、肌酸和磷酸肌酸（Cr）以及乳酸（Lac）的波谱。测量了代谢物的绝对浓度并计算了它们的比率。然后确定这些与肿瘤组织学和分级之间的相关性。Cho和Lac的浓度以及Cho/NAA比率是区分良性（世界卫生组织I级和II级）和恶性肿瘤（世界卫生组织III级和IV级），特别是毛细胞型星形细胞瘤和髓母细胞瘤的主要统计学显著参数。无法区分恶性和良性肿瘤组内的各个组织学类型。小儿后颅窝肿瘤的质子MRS似乎有助于预测肿瘤分级和组织学。该检查的特殊性要求为每台MR扫描仪建立个体标准。
