质子磁共振波谱在鉴别胶质母细胞瘤与原发性脑淋巴瘤及脑转移瘤中的应用

Proton magnetic resonance spectroscopy in differentiating glioblastomas from primary cerebral lymphomas and brain metastases.

作者信息

Chawla Sanjeev, Zhang Yu, Wang Sumei, Chaudhary Sangeeta, Chou Chou, O'Rourke Donald M, Vossough Arastoo, Melhem Elias R, Poptani Harish

机构信息

Department of Radiology, University of Pennsylvania, Philadelphia, PA 19104, USA.

出版信息

J Comput Assist Tomogr. 2010 Nov-Dec;34(6):836-41. doi: 10.1097/RCT.0b013e3181ec554e.

DOI:10.1097/RCT.0b013e3181ec554e

PMID:21084897

Abstract

OBJECTIVE

To differentiate glioblastomas, primary cerebral lymphomas (PCLs), and brain metastases using multivoxel proton magnetic resonance (MR) spectroscopic imaging.

METHODS

A total of 56 patients with brain neoplasms underwent MR imaging and proton MR spectroscopic imaging. The data were analyzed from contrast-enhancing and peritumoral regions (PTR). N-acetylaspartate/creatine (Cr), choline (Cho)/Cr, glutamate+glutamine/Cr, myo-inositol/Cr, and lipids+lactate/Cr ratios were computed, and pairwise comparisons between neoplasms were made using Mann-Whitney U tests.

RESULTS

The PTR demonstrated most significant differences in metabolite ratios. The Cho/Cr ratio in glioblastomas (0.46 [0.01]) was significantly higher than that in metastases (0.38 [0.02], P = 0.01). Significantly elevated Cho/Cr levels were also noted in PCLs (0.48 [0.03]) compared with those in metastases (P = 0.04). In addition, PCLs also demonstrated significantly higher lipids+lactate/Cr levels (11.83 [2.59]) compared with glioblastomas (4.50 [0.59], P = 0.003) and metastases (2.79 [0.33], P = 0.001).

CONCLUSIONS

Proton MR spectroscopic imaging from PTR may assist in the differentiation of glioblastomas, metastases, and PCLs.

摘要

目的

利用多体素质子磁共振（MR）波谱成像鉴别胶质母细胞瘤、原发性脑淋巴瘤（PCL）和脑转移瘤。

方法

共有56例脑肿瘤患者接受了MR成像和质子MR波谱成像检查。对增强区域和瘤周区域（PTR）的数据进行分析。计算N-乙酰天门冬氨酸/肌酸（Cr）、胆碱（Cho）/Cr、谷氨酸+谷氨酰胺/Cr、肌醇/Cr以及脂质+乳酸/Cr的比值，并使用曼-惠特尼U检验对肿瘤之间进行两两比较。

结果

PTR在代谢物比值方面显示出最显著的差异。胶质母细胞瘤的Cho/Cr比值（0.46 [0.01]）显著高于转移瘤（0.38 [0.02]，P = 0.01）。与转移瘤相比，PCL中的Cho/Cr水平也显著升高（0.48 [0.03]，P = 0.04）。此外，与胶质母细胞瘤（4.50 [0.59]，P = 0.003）和转移瘤（2.79 [0.33]，P = 0.001）相比，PCL的脂质+乳酸/Cr水平也显著更高（11.83 [2.59]）。