Papanagiotou P, Backens M, Grunwald I Q, Farmakis G, Politi M, Roth C, Reith W
Klinik für Diagnostische und Interventionelle Neuroradiologie, Universitätsklinikum des Saarlandes, Homburg, Saar.
Radiologe. 2007 Jun;47(6):520-9. doi: 10.1007/s00117-007-1522-8.
MRT allows the anatomical visualization of intracerebral space-occupying lesions, and when magnetic resonance spectroscopy (MRS) is used in routine clinical practice it can give more information and be helpful in the diagnosis of such lesions. In MRS with long echo times for nerve tissue there are five metabolites that are particularly significant: N-acetyl aspartate (NAA), creatine, choline, lactate, and lipids. NAA levels are lowered in the presence of intracerebral tumors. Creatine is lowered in situations of hypermetabolic metabolism and elevated in hypometabolic conditions, but remains constant in many pathologic states and can be used as a reliable reference value. With malignant tumors there are usually elevated choline concentrations, reflecting increased membrane synthesis and a higher cell turnover. The lactate level rises following a switch in metabolism from aerobic to anaerobic glycolysis, and this is frequently observed in the presence of malignant tumors. The occurrence of lipid peaks in a tumor spectrum suggests the presence of tissue necroses or metastases. There are typical constellations that are seen on MRS for individual tumors, which are discussed in detail in the present paper.
磁共振成像（MRT）能够对脑内占位性病变进行解剖学可视化，并且当磁共振波谱（MRS）应用于常规临床实践时，它可以提供更多信息，有助于此类病变的诊断。在对神经组织采用长回波时间的MRS中，有五种代谢物尤为重要：N-乙酰天门冬氨酸（NAA）、肌酸、胆碱、乳酸和脂质。脑内肿瘤存在时NAA水平会降低。肌酸在高代谢状态下降低，在低代谢状态下升高，但在许多病理状态下保持恒定，可作为可靠的参考值。恶性肿瘤时胆碱浓度通常升高，反映膜合成增加和细胞更新率更高。代谢从有氧糖酵解转变为无氧糖酵解后乳酸水平升高，这在恶性肿瘤存在时经常观察到。肿瘤波谱中脂质峰的出现提示存在组织坏死或转移。MRS上针对个别肿瘤会出现典型的组合情况，本文将对此进行详细讨论。
