Radiology Department, I.R.C.C.S. -C.R.O.B., Rionero in Vulture, Potenza, Italy.
Int J Neurosci. 2013 Aug;123(8):537-43. doi: 10.3109/00207454.2013.774395. Epub 2013 Mar 11.
The aim of the present study is to report about the value of magnetic resonance spectroscopy (MRS) in differentiating brain metastases, primary high-grade gliomas (HGG) and low-grade gliomas (LGG). MRI (magnetic resonance imaging) and MRS were performed in 60 patients with histologically verified brain tumors: 32 patients with HGG (28 glioblastomas multiforme [GBM] and 4 anaplastic astrocytomas), 14 patients with LGG (9 astrocytomas and 5 oligodendrogliomas) and 14 patients with metastatic brain tumors. The Cho/Cr (choline-containing compounds/creatine-phosphocreatine complex), Cho/NAA (N-acetyl aspartate) and NAA/Cr ratios were assessed from spectral maps in the tumoral core and peritumoral edema. The differences in the metabolite ratios between LGG, HGG and metastases were analyzed statistically. Lipids/lactate contents were also analyzed. Significant differences were noted in the tumoral and peritumoral Cho/Cr, Cho/NAA and NAA/Cr ratios between LGG, HGG and metastases. Lipids and lactate content revealed to be useful for discriminating gliomas and metastases. The results of this study demonstrate that MRS can differentiate LGG, HGG and metastases, therefore diagnosis could be allowed even in those patients who cannot undergo biopsy.
本研究旨在报告磁共振波谱（MRS）在鉴别脑转移瘤、高级别胶质瘤（HGG）和低级别胶质瘤（LGG）方面的价值。对 60 例经组织学证实的脑肿瘤患者进行 MRI（磁共振成像）和 MRS 检查：32 例 HGG（28 例多形性胶质母细胞瘤[GBM]和 4 例间变性星形细胞瘤）、14 例 LGG（9 例星形细胞瘤和 5 例少突胶质细胞瘤）和 14 例转移性脑肿瘤。在肿瘤核心和瘤周水肿的光谱图中评估 Cho/Cr（含胆碱化合物/肌酸磷酸肌酸复合物）、Cho/NAA（N-乙酰天冬氨酸）和 NAA/Cr 比值。分析 LGG、HGG 和转移瘤之间代谢物比值的差异。还分析了脂质/乳酸含量。在 LGG、HGG 和转移瘤之间，肿瘤和瘤周 Cho/Cr、Cho/NAA 和 NAA/Cr 比值存在显著差异。脂质和乳酸含量有助于鉴别胶质瘤和转移瘤。本研究结果表明，MRS 可区分 LGG、HGG 和转移瘤，因此即使对于那些不能进行活检的患者，也可以进行诊断。
