Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona 85013, USA.
Neurosurg Focus. 2010 Jan;28(1):E12. doi: 10.3171/2009.11.FOCUS09216.
The goal in this study was to determine if proton ((1)H) MR spectroscopy can differentiate meningioma grade and is associated with interpretations of biological behavior; the study was performed using ex vivo high-resolution spectra indicating metabolic characteristics.
Sixty-eight resected tissue samples of meningiomas were examined using ex vivo (1)H MR spectroscopy. Of these meningiomas, 46 were WHO Grade I, 14 were WHO Grade II, and 8 were WHO Grade III. Fifty-nine were primary meningiomas and 9 were recurrences. Invasion of adjacent tissue (dura mater, bone, venous sinus, brain) was found in 32 cases. Thirty-nine meningiomas did not rapidly recur (as defined by expansion on MR imaging within a 5-year follow-up period), whereas rapid recurrence was confirmed in 24 meningiomas, and follow-up status was unknown in 5 cases.
The absolute concentrations of total alanine and creatine were decreased in high-grade compared with low-grade meningiomas, as was the ratio of glycine to alanine (all p < 0.05). Additionally, alanine and the glycine/alanine ratio distinguished between primary and recurrent meningiomas (all p < 0.05). Finally, the absolute concentrations of alanine and creatine, and the glycine/alanine and choline/glutamate ratios were associated with rapid recurrence (p < 0.05).
These data indicate that meningioma tissue can be characterized by metabolic parameters that are not typically identified by histopathological analysis alone. Creatine, glycine, and alanine may be used as markers of meningioma grade, recurrence, and the likelihood of rapid recurrence. These data validate a previous study of a separate group of Grade I meningiomas.
本研究旨在确定质子（1H）磁共振波谱是否可以区分脑膜瘤的分级，并与生物学行为的解读相关联；该研究使用离体高分辨率谱来进行，以指示代谢特征。
使用离体 1H MR 光谱检查了 68 例脑膜瘤切除组织样本。这些脑膜瘤中，46 例为世界卫生组织（WHO）分级 I，14 例为 WHO 分级 II，8 例为 WHO 分级 III。59 例为原发性脑膜瘤，9 例为复发。在 32 例病例中发现了临近组织（硬脑膜、骨骼、静脉窦、脑组织）的侵犯。39 例脑膜瘤未迅速复发（定义为在 5 年随访期内 MRI 上的扩张），而 24 例脑膜瘤确认了快速复发，5 例的随访状态未知。
与低级别脑膜瘤相比，高级别脑膜瘤中的总丙氨酸和肌酸的绝对浓度降低，而甘氨酸与丙氨酸的比值也降低（均 p < 0.05）。此外，丙氨酸和甘氨酸/丙氨酸比值可以区分原发性和复发性脑膜瘤（均 p < 0.05）。最后，丙氨酸和肌酸的绝对浓度以及甘氨酸/丙氨酸和胆碱/谷氨酸的比值与快速复发相关（p < 0.05）。
这些数据表明，脑膜瘤组织可以通过代谢参数来进行特征描述，而这些参数通常不能仅通过组织病理学分析来识别。肌酸、甘氨酸和丙氨酸可以作为脑膜瘤分级、复发以及快速复发可能性的标志物。这些数据验证了先前对一组独立的 I 级脑膜瘤的研究。
