Department of Radiology, College of Medicine, Dong-A University, Busan 602-715, Korea.
Korean J Radiol. 2013 May-Jun;14(3):477-86. doi: 10.3348/kjr.2013.14.3.477. Epub 2013 May 2.
To evaluate the clinical feasibility and obtain useful parameters of (31)P magnetic resonance spectroscopy (MRS) study for making the differential diagnosis of brain tumors.
Twenty-eight patients with brain tumorous lesions (22 cases of brain tumor and 6 cases of abscess) and 11 normal volunteers were included. The patients were classified into the astrocytoma group, lymphoma group, metastasis group and the abscess group. We obtained the intracellular pH and the metabolite ratios of phosphomonoesters/phosophodiesters (PME/PDE), PME/inorganic phosphate (Pi), PDE/Pi, PME/adenosine triphosphate (ATP), PDE/ATP, PME/phosphocreatine (PCr), PDE/PCr, PCr/ATP, PCr/Pi, and ATP/Pi, and evaluated the statistical significances.
The brain tumors had a tendency of alkalization (pH = 7.28 ± 0.27, p = 0.090), especially the pH of the lymphoma was significantly increased (pH = 7.45 ± 0.32, p = 0.013). The brain tumor group showed increased PME/PDE ratio compared with that in the normal control group (p = 0.012). The ratios of PME/PDE, PDE/Pi, PME/PCr and PDE/PCr showed statistically significant differences between each brain lesion groups (p < 0.05). The astrocytoma showed an increased PME/PDE and PME/PCr ratio. The ratios of PDE/Pi, PME/PCr, and PDE/PCr in lymphoma group were lower than those in the control group and astrocytoma group. The metastasis group showed an increased PME/PDE ratio, compared with that in the normal control group.
We have obtained the clinically applicable (31)P MRS, and the pH, PME/PDE, PDE/Pi, PME/PCr, and PDE/PCr ratios are helpful for differentiating among the different types of brain tumors.
评估(31)P 磁共振波谱(MRS)检查在脑肿瘤鉴别诊断中的临床可行性并获得有用的参数。
共纳入 28 例脑肿瘤性病变患者(22 例脑肿瘤,6 例脑脓肿)和 11 名正常志愿者。患者分为星形细胞瘤组、淋巴瘤组、转移瘤组和脑脓肿组。我们获得了细胞内 pH 值和磷酸单酯/二酯(PME/PDE)、PME/无机磷(Pi)、PDE/Pi、PME/三磷酸腺苷(ATP)、PDE/ATP、PME/磷酸肌酸(PCr)、PDE/PCr、PCr/ATP、PCr/Pi 和 ATP/Pi 的代谢物比值,并评估了其统计学意义。
脑肿瘤有碱化趋势(pH = 7.28 ± 0.27,p = 0.090),特别是淋巴瘤的 pH 值明显升高(pH = 7.45 ± 0.32,p = 0.013)。脑肿瘤组与正常对照组相比,PME/PDE 比值升高(p = 0.012)。各组脑病变之间的 PME/PDE、PDE/Pi、PME/PCr 和 PDE/PCr 比值均有统计学差异(p < 0.05)。星形细胞瘤组表现为 PME/PDE 和 PME/PCr 比值升高。淋巴瘤组的 PDE/Pi、PME/PCr 和 PDE/PCr 比值低于对照组和星形细胞瘤组。转移瘤组与正常对照组相比,PME/PDE 比值升高。
我们获得了具有临床应用价值的(31)P MRS,pH 值、PME/PDE、PDE/Pi、PME/PCr 和 PDE/PCr 比值有助于鉴别不同类型的脑肿瘤。