质子磁共振波谱成像及表观扩散系数在脑实质病变评估中的应用

Proton magnetic resonance spectroscopy and apparent diffusion coefficient in evaluation of solid brain lesions.

作者信息

Balos Dragana Ristić, Gavrilović Svetlana, Lavrnić Slobodan, Vasić Brankica, Macvanski Marija, Damjanović Dusan, Opinćal Tatjana Stosić

机构信息

Radiology and Magnetic Resonance Imaging Center, Clinical Center of Serbia, Belgrade, Serbia.

出版信息

Vojnosanit Pregl. 2013 Jul;70(7):637-44. doi: 10.2298/vsp110223044r.

DOI:10.2298/vsp110223044r

PMID:23984611

Abstract

BACKGROUND/AIM: Advanced magnetic resonance techniques can provide insight in physiological changes within pathological canges and contribute to better distinquishing between different tumor types and their discrimination from non-neoplastic lesions. The aim of this study was to evaluate the role of proton magnetic resonance spectroscopy (1H-MRS) and apparent diffusion coefficients (ADC) in distinguishing intracranial glial tumors from tumor like nonneoplastic lesions, as well as for differentiating high- from low-grade gliomas.

METHODS

This retrospective study included 47 patients with solid brain lesions (25 nonneoplastic, 14 low-grade and 8 anaplastic glial tumors). In all patients 1H-MRS (at a TE of 135 ms and 30 ms) and diffusion-weighted imaging (DWI) were performed. The choline to creatine (Cho/Cr), choline to N-acetyl aspartate (Cho/NAA), N-acetyl aspartate to creatine (NAA/Cr) and myoinositol to creatine (mIn/Cr) ratios and the apparent diffusion coefficient (ADC) were determined.

RESULTS

The Cho/Cr ratio was significantly higher in glial tumors grade II than in non-neoplastic lesions (p = 0.008) and in glial tumors grade III than in non-neoplastic lesions (p = 0.001). The Cho/NAA ratio was significantly higher in glial tumors grade II than in non-neoplastic lesions (p = 0.037). AADC/ADC between glial tumors grade II and glial tumors grade III showed a statistical significance (p = 0.023).

CONCLUSION

Our study showed that 1H-MRS and apparent diffusion coefficients can help in evaluation and differentiation of solid brain lesions.

摘要

背景/目的：先进的磁共振技术能够深入了解病理变化中的生理改变，有助于更好地区分不同肿瘤类型以及将它们与非肿瘤性病变区分开来。本研究的目的是评估质子磁共振波谱（1H-MRS）和表观扩散系数（ADC）在区分颅内胶质肿瘤与肿瘤样非肿瘤性病变以及区分高级别与低级别胶质瘤方面的作用。

方法

这项回顾性研究纳入了47例脑实质病变患者（25例非肿瘤性病变、14例低级别胶质肿瘤和8例间变性胶质肿瘤）。对所有患者均进行了1H-MRS（回波时间为135 ms和30 ms）和扩散加权成像（DWI）检查。测定了胆碱与肌酸（Cho/Cr）、胆碱与N-乙酰天门冬氨酸（Cho/NAA）、N-乙酰天门冬氨酸与肌酸（NAA/Cr）以及肌醇与肌酸（mIn/Cr）的比值和表观扩散系数（ADC）。

结果

二级胶质肿瘤的Cho/Cr比值显著高于非肿瘤性病变（p = 0.008），三级胶质肿瘤的Cho/Cr比值显著高于非肿瘤性病变（p = 0.001）。二级胶质肿瘤的Cho/NAA比值显著高于非肿瘤性病变（p = 0.037）。二级胶质肿瘤与三级胶质肿瘤之间的AADC/ADC具有统计学意义（p = 0.023）。