Murphy P S, Rowland I J, Viviers L, Brada M, Leach M O, Dzik-Jurasz A S K
Cancer Research UK Clinical MR Research Group, The Institute of Cancer Research and The Royal Marsden NHS Trust, Sutton, Surrey SM2 5PT, UK.
Br J Radiol. 2003 Jul;76(907):459-63. doi: 10.1259/bjr/16316438.
The potential clinical role of in vivo (1)H-MRS ((1)H-magnetic resonance spectroscopy) lipid methylene resonance measurements of human glioma has been assessed. 20 patients, 14 with low grade and 6 with high grade gliomas have been investigated using single voxel (1)H-MRS. Three of the low grade group had undergone transformation by clinical and imaging criteria. Short echo time (TE=20 ms, TR=2500 ms) single voxel Stimulated Echo Acquisition (STEAM) spectra with (acquisitions=64) and without (acquisitions=4) water suppression were acquired. Additionally, T(1) weighted (T(1)W) water spectra (TE=20 ms, TR=888 ms) were acquired pre- and post-injection of Gd-DTPA (0.2 mmol x kg(-1)). The T(1)W water spectra were used to determine the water proton enhancement occurring within the spectroscopic voxel. The enhancement expressed as a percentage was compared with the lipid methylene peak. All the high grade tumours had significantly higher levels of lipid than low grade tumours (p=0.002). Low grade tumours had significantly less water proton enhancement than transformers (p=0.04) and high grade tumours (p=0.001). The lipid methylene signal correlated strongly with the voxel water enhancement (r(2)=0.74, p<0.0001). The data support the view that the spectroscopically detected lipid methylene signal may be a useful criterion in grading glioma. The correlation of the lipid methylene signal with blood-brain barrier breakdown suggests that detection of a previously absent (1)H-MRS lipid methylene signal in low grade tumours might be an early indicator of transformation.
已评估了体内氢磁共振波谱（¹H-MRS）对人类胶质瘤脂质亚甲基共振测量的潜在临床作用。使用单体素¹H-MRS对20例患者进行了研究，其中14例为低级别胶质瘤，6例为高级别胶质瘤。低级别组中有3例已根据临床和影像学标准发生了肿瘤转化。采集了短回波时间（TE = 20 ms，TR = 2500 ms）的单体素激励回波采集（STEAM）谱，其中有（采集次数 = 64）和没有（采集次数 = 4）水抑制的情况。此外，在注射钆喷酸葡胺（0.2 mmol·kg⁻¹）之前和之后采集了T1加权（T1W）水谱（TE = 20 ms，TR = 888 ms）。T1W水谱用于确定光谱体素内发生的水质子增强。将以百分比表示的增强与脂质亚甲基峰进行比较。所有高级别肿瘤的脂质水平均显著高于低级别肿瘤（p = 0.002）。低级别肿瘤的水质子增强明显少于发生转化的肿瘤（p = 0.04）和高级别肿瘤（p = 0.001）。脂质亚甲基信号与体素水增强密切相关（r² = 0.74，p < 0.0001）。数据支持以下观点：光谱检测到的脂质亚甲基信号可能是胶质瘤分级的有用标准。脂质亚甲基信号与血脑屏障破坏的相关性表明，在低级别肿瘤中检测到先前不存在的¹H-MRS脂质亚甲基信号可能是肿瘤转化的早期指标。
