Alam Muhammad Shahbaz, Ahsan Humera, Sajjad Zafar, Beg Madiha, Bhatti Umer, Enam Ather, Wasay Muhammad
J Pak Med Assoc. 2014 Oct;64(10):1141-5.
To investigate the efficacy of magnetic resonance spectroscopy in differentiating various types of neoplastic and non-neoplastic enhancing cerebral lesions.
The prospective study was conducted from January 2007 to December 2009 at the Department of Radiology, Aga Khan University Hospital, Karachi. All patients with enhancing brain lesions on magnetic resonance imaging who underwent magnetic resonance spectroscopy and a biopsy with histopathological analysis were included in study. The lesions were categorised into neoplastic and non-neoplastic lesions on the basis of spectroscopy findings. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of magnetic resonance spectroscopy were calculated. Predicted probabilities were computed and comparison of median values of metabolites and their ratios was analysed using non-parametric Mann Whitney U test to differentiate between neoplastic and non-neoplastic lesions.
Of the 102 patients enrolled, 78 (76.5%) comprised the final study sample. There were 53 (68%) male and 25 (32%) female patients with an overall mean age of 40.21 ± 17.69 years (range: 4-76 years). The mean overall size of the lesion was 4.01 ± 1.79 cm, and 61(78%) lesions were neoplastic and 17 (22%) were non-neoplastic. The sensitivity, specificity, positive predictive value and negative predictive value and diagnostic accuracy of magnetic resonance spectroscopy in differentiating neoplastic and non-neoplastic lesions were 90.16%, 64.70%, 90.16%, 64.70% and 78.20% respectively. A cut-off value of 2.55 of Choline/N-Acetyl Aspartate ratio depicted sensitivity of 70% in differentiating the lesions.
Magnetic resonance spectroscopy is a highly sensitive technique in addition to conventional magnetic resonance imaging in characterising and differentiating between neoplastic and non-neoplastic cerebral lesions.
探讨磁共振波谱在鉴别各种类型的肿瘤性和非肿瘤性强化脑病变中的疗效。
前瞻性研究于2007年1月至2009年12月在卡拉奇阿迦汗大学医院放射科进行。纳入所有在磁共振成像上有强化脑病变且接受了磁共振波谱检查和组织病理学分析活检的患者。根据波谱结果将病变分为肿瘤性和非肿瘤性病变。计算磁共振波谱的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性。计算预测概率，并使用非参数曼-惠特尼U检验分析代谢物及其比率的中位数差异，以区分肿瘤性和非肿瘤性病变。
在纳入的102例患者中，78例（76.5%）构成最终研究样本。有53例（68%）男性和25例（32%）女性患者，总体平均年龄为40.21±17.69岁（范围：4 - 76岁）。病变的平均总体大小为4.01±1.79 cm，61例（78%）病变为肿瘤性，17例（22%）为非肿瘤性。磁共振波谱在鉴别肿瘤性和非肿瘤性病变中的敏感性、特异性、阳性预测值、阴性预测值和诊断准确性分别为90.16%、64.70%、90.16%、64.70%和78.20%。胆碱/ N - 乙酰天门冬氨酸比率的截断值为2.55时，在鉴别病变中敏感性为70%。
除传统磁共振成像外，磁共振波谱在表征和鉴别肿瘤性和非肿瘤性脑病变方面是一种高度敏感的技术。
