Matsusue Eiji, Inoue Chie, Tabuchi Sadaharu, Yoshioka Hiroki, Nagao Yuichiro, Matsumoto Kensuke, Nakamura Kazuhiko, Fujii Shinya
Department of Radiology, Tottori Prefectural Central Hospital, Tottori, Japan.
Department of Neurosurgery, Tottori Prefectural Central Hospital, Tottori, Japan.
Acta Radiol Open. 2021 Apr 19;10(4):20584601211009472. doi: 10.1177/20584601211009472. eCollection 2021 Apr.
Proton magnetic resonance spectroscopy (MRS) provides structural and metabolic information that is useful for the diagnosis of meningiomas with atypical radiological appearance. However, the metabolite that should be prioritized for the diagnosis of meningiomas has not been established.
To evaluate the differences between the metabolic peaks of meningiomas and other intracranial enhanced mass lesions (non-meningiomas) using MR spectroscopy in short echo time (TE) spectra and the most useful metabolic peak for discriminating between the groups.
The study involved 9 meningiomas, 22 non-meningiomas, intracranial enhancing tumors and abscesses, and 15 normal controls. The ranking of the peak at 3.8 ppm, peak at 3.8 ppm/Creatine (Cr), β-γ Glutamine-Glutamate (bgGlx)/Cr, N-acetyl compounds (NACs)/Cr, choline (Cho)/Cr, lipid and/or lactate (Lip-Lac) at 1.3 ppm/Cr, and the presence of alanine (Ala) were derived. The metabolic peaks were compared using the Mann-Whitney U test. ROC analysis was used to determine the cut-off values for differentiating meningiomas from non-meningiomas using statistically significant metabolic peaks.
The ranking of the peak at 3.8 ppm among all the peaks, peak at 3.8 ppm/Cr, bgGlx/Cr, Lip-Lac/Cr, and the presence of Ala discriminated meningiomas from non-meningiomas with moderate to high accuracy. The highest accuracy was 96.9% at a threshold value of 3 for the rank of the peak at 3.8 ppm.
A distinct elevated peak at 3.8 ppm, ranked among the top three highest peaks, allowed the detection of meningiomas.
质子磁共振波谱（MRS）提供的结构和代谢信息有助于诊断具有非典型放射学表现的脑膜瘤。然而，尚未确定用于脑膜瘤诊断的优先代谢物。
利用短回波时间（TE）谱的磁共振波谱评估脑膜瘤与其他颅内强化肿块性病变（非脑膜瘤）代谢峰之间的差异，以及区分两组最有用的代谢峰。
该研究纳入9例脑膜瘤、22例非脑膜瘤（颅内强化肿瘤和脓肿）以及15例正常对照。得出3.8 ppm处峰的排名、3.8 ppm处峰与肌酸（Cr）的比值、β-γ谷氨酰胺-谷氨酸（bgGlx）与Cr的比值、N-乙酰化合物（NACs）与Cr的比值、胆碱（Cho）与Cr的比值、1.3 ppm处脂质和/或乳酸（Lip-Lac）与Cr的比值以及丙氨酸（Ala）的存在情况。使用曼-惠特尼U检验比较代谢峰。采用ROC分析确定使用具有统计学意义的代谢峰区分脑膜瘤与非脑膜瘤的临界值。
3.8 ppm处峰的排名、3.8 ppm处峰与Cr的比值、bgGlx与Cr的比值、Lip-Lac与Cr的比值以及Ala的存在情况能够以中到高准确度区分脑膜瘤与非脑膜瘤。3.8 ppm处峰的排名阈值为3时，最高准确度为96.9%。
在最高的三个峰中排名靠前的3.8 ppm处明显升高的峰有助于脑膜瘤的检测。
