Department of Radiology, the First Affiliated Hospital, Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing 400016, China.
Eur J Radiol. 2012 Dec;81(12):4057-63. doi: 10.1016/j.ejrad.2012.06.005. Epub 2012 Jul 1.
The purpose of this study was to determine whether proton MR spectroscopy ((1)H MRS) and diffusion-weighted (DW) imaging can be used to differentiate intracranial tuberculomas from high grade gliomas (HGGs).
A total of 41 patients (19 with intracranial tuberculomas and 22 with HGGs) were examined in our study. (1)H MRS and DW imaging were performed at a 1.5T MR scanner before operation or treatment. Concentrations of N-acetylaspartate (NAA), creatine (Cr), choline (Cho), and lipid and lactate (LL) in the contrast-enhancing rim of each lesion were expressed as metabolite ratios and were normalized to the contralateral hemisphere. The apparent diffusion coefficient (ADC) was also calculated. The metabolite ratios and ADC values in the enhancing rim of intracranial tuberculomas and HGGs were compared using the Wilcoxon rank sum test. Diagnostic accuracy was compared using receiver operating characteristic (ROC) analysis.
Significant differences were found in the maximum Cho/Cr (P=0.015), Cho/NAA (P=0.001) and Cho/Cho-n ratios (P=0.002), and minimum ADC value (P<0.001) between the intracranial tuberculomas and HGGs. Diagnostic accuracy was higher by minimum ADC value than maximum Cho/Cr, Cho/NAA and Cho/Cho-n ratios (93.8% versus 75.7%, 80.8% and 78.1%).
These results suggest a promising role for (1)H MRS and DW imaging in the differentiation between the intracranial tuberculomas and HGGs.
本研究旨在探讨质子磁共振波谱（1H MRS）和弥散加权成像（DW）是否可用于鉴别颅内结核瘤与高级别胶质瘤（HGG）。
本研究共纳入 41 例患者（颅内结核瘤 19 例，HGG 22 例）。所有患者均于术前或治疗前行 1.5T 磁共振检查，包括 1H MRS 和 DW 成像。通过比较病变强化环的 N-乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱（Cho）、脂质和乳酸（LL）浓度的代谢物比值，并将其与对侧半球进行归一化，计算Cho/Cr、Cho/NAA 和 Cho/Cho-n 比值以及表观弥散系数（ADC）。采用 Wilcoxon 秩和检验比较颅内结核瘤和 HGG 强化环的代谢物比值和 ADC 值。采用受试者工作特征（ROC）曲线分析比较诊断准确性。
颅内结核瘤与 HGG 之间的最大 Cho/Cr（P=0.015）、Cho/NAA（P=0.001）和 Cho/Cho-n 比值（P=0.002）及最小 ADC 值（P<0.001）存在显著差异。最小 ADC 值的诊断准确性优于最大 Cho/Cr、Cho/NAA 和 Cho/Cho-n 比值（93.8% vs. 75.7%、80.8%和 78.1%）。
1H MRS 和 DW 成像有助于鉴别颅内结核瘤与 HGG。
