The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
AJR Am J Roentgenol. 2010 Jul;195(1):W69-75. doi: 10.2214/AJR.09.3718.
The purpose of this study is to establish the feasibility and potential value of measuring the concentration of choline-containing compounds by proton MR spectroscopy (MRS) in musculoskeletal lesions at 3 T.
Thirty-three subjects with 34 musculoskeletal lesions (four histologically proven malignant, 13 histologically proven benign or proven benign by follow-up analysis, and 17 posttreatment fibrosis with documented stability for 6-36 months) underwent single-voxel 3-T MRS studies. In each case, both water-suppressed and water-unsuppressed scans were obtained. The quality of the scans was recorded as excellent, adequate, or nondiagnostic, and the choline concentration was measured using water as the internal reference. The choline concentrations of benign and malignant lesions were compared using the Mann-Whitney test.
Spectral quality was excellent in 26 cases, adequate in four cases, and nondiagnostic in four cases. For malignant lesions (three sarcomas), the choline concentrations were 1.5, 2.9, and 3.8 mmol/kg, respectively. For five benign lesions (two neurofibromas, two schwannomas, and one enchondroma), the choline concentrations were 0.11, 0.28, 0.13, 0.8, and 1.2 mmol/kg, respectively. For seven benign lesions (two hematomas, two bone cysts, one lipoma, one giant cell tumor, and one pigmented villonodular synovitis), the spectra showed negligible choline content. For three posttreatment fibrosis cases, the choline concentration range was 0.2-0.4 mmol/kg. For the remaining 12 posttreatment fibrosis cases, the spectra showed negligible choline content. Average choline concentrations were different for malignant and benign lesions (2.7 vs 0.5 mmol/kg; p = 0.01).
The measurement of choline concentration within musculoskeletal lesions by MRS is feasible using an internal water-referencing method at 3 T and has potential for characterizing lesions for malignancy.
本研究旨在确定在 3T 磁共振质子波谱（MRS）测量骨骼肌病变中含胆碱化合物浓度的可行性和潜在价值。
33 名受试者的 34 个骨骼肌病变（4 个经组织学证实为恶性，13 个经组织学证实为良性或经随访分析证实为良性，17 个为治疗后纤维化，稳定性为 6-36 个月）接受了单体素 3T MRS 研究。在每种情况下，均获得了水抑制和非水抑制扫描。记录扫描质量为优秀、充分或不可诊断，并使用水作为内部参考测量胆碱浓度。使用 Mann-Whitney 检验比较良性和恶性病变的胆碱浓度。
26 例扫描质量优秀，4 例充分，4 例不可诊断。对于恶性病变（3 例肉瘤），胆碱浓度分别为 1.5、2.9 和 3.8mmol/kg。对于 5 个良性病变（2 个神经纤维瘤、2 个神经鞘瘤和 1 个软骨瘤），胆碱浓度分别为 0.11、0.28、0.13、0.8 和 1.2mmol/kg。对于 7 个良性病变（2 个血肿、2 个骨囊肿、1 个脂肪瘤、1 个巨细胞瘤和 1 个色素绒毛结节性滑膜炎），光谱显示胆碱含量可忽略不计。对于 3 例治疗后纤维化病例，胆碱浓度范围为 0.2-0.4mmol/kg。对于其余 12 例治疗后纤维化病例，光谱显示胆碱含量可忽略不计。恶性和良性病变的平均胆碱浓度不同（2.7 与 0.5mmol/kg；p=0.01）。
使用内部水参照方法在 3T 下进行 MRS 测量骨骼肌病变中的胆碱浓度是可行的，并且具有对病变进行恶性特征描述的潜力。
