Peter S Babu, Nandhan V Raghu
Department of Radiodiagnosis, Barnard Institute of Radiology, Madras Medical College, Chennai, Tamil Nadu, India.
Indian J Radiol Imaging. 2022 Jan 10;31(4):873-881. doi: 10.1055/s-0041-1741090. eCollection 2021 Oct.
31-Phosphorus magnetic resonance spectroscopy (31-P MRS) has excellent potential for clinical neurological practice because of its noninvasive in-vivo assessment of cellular energy metabolism and the indirect evaluation of the phospholipid composition of the cell membrane, intracellular pH, and intracellular Mg2+ concentration. The aim of this study was to evaluate the metabolic characteristics of glioma and metastases using 31-P MRS and assess utility to differentiate both. Prospective study. Fifteen consecutive patients with brain tumor. Three-tesla magnetic resonance imaging/three-dimensional MRS imaging sequence. Unpaired sample -test, and one-way analysis of variance with Tukey's post-hoc test. Significantly decreased values of phosphomonoesters/inorganic phosphate (PME/Pi) in the tumor group (1.22 ± 0.72) compared with controls (2.28 ± 1.44) with a -value of 0.041 were observed. There is a significant decrease in phosphocreatine (PCr)/Pi values (energy demand) in the tumor group (2.76 ± 0.73) compared with controls (4.13 ± 1.75) with a -value of 0.050. Significant increase in Pi/adenosine triphosphate (ATP) was noted in tumor group (0.28 ± 0.09) compared with controls (0.22 ± 0.08) with -value 0.049. Among tumor group, PME/PCr values were significantly decreased in gliomas (0.35 ± 0.17) than metastasis (0.58 ± 0.23) compared with controls with a -value of 0.047. A significant decrease in PME/ATP was noted in gliomas (0.25 ± 0.12) than metastasis (0.41 ± 0.14) compared with controls with a -value of 0.034. The tumor group exhibits alkaline pH (7.12 ± 0.10) compared with the normal parenchyma (7.04 ± 0.06) with a significant -value of 0.025. Glioma and metastasis could not be differentiated with pH. However, the perilesional edema of glioma shows alkaline pH (7.09 ± 0.06) and metastasis shows acidic pH (7.02 ± 0.05) with a significant -value of 0.030. Our study provides new insight into the cellular constituents and pH of gliomas and metastases and results were significant in differentiation between these two. However, due to the additional high expense, it is available as a research tool in very few institutions in India.
31-磷磁共振波谱（31-P MRS）在临床神经学实践中具有巨大潜力，因为它能够对细胞能量代谢进行无创体内评估，并间接评估细胞膜的磷脂组成、细胞内pH值和细胞内Mg2+浓度。本研究的目的是使用31-P MRS评估胶质瘤和转移瘤的代谢特征，并评估其对两者进行鉴别诊断的效用。前瞻性研究。连续纳入15例脑肿瘤患者。采用3特斯拉磁共振成像/三维MRS成像序列。采用非配对样本t检验以及带有Tukey事后检验的单因素方差分析。结果观察到，与对照组（2.28±1.44）相比，肿瘤组的磷酸单酯/无机磷酸盐（PME/Pi）值显著降低（1.22±0.72），P值为0.041。与对照组（4.13±1.75）相比，肿瘤组的磷酸肌酸（PCr）/Pi值（能量需求）显著降低（2.76±0.73），P值为0.050。与对照组（0.22±0.08）相比，肿瘤组的Pi/三磷酸腺苷（ATP）显著升高（0.28±0.09），P值为0.049。在肿瘤组中，与对照组相比，胶质瘤的PME/PCr值（0.35±0.17）显著低于转移瘤（0.58±0.23），P值为0.047。与对照组相比，胶质瘤的PME/ATP值（0.25±0.12）显著低于转移瘤（0.41±0.14），P值为0.034。与正常脑实质（7.04±0.06）相比，肿瘤组呈现碱性pH值（7.12±0.10），P值具有显著性，为0.025。无法通过pH值区分胶质瘤和转移瘤。然而，胶质瘤的瘤周水肿呈现碱性pH值（7.09±0.06），转移瘤呈现酸性pH值（7.02±0.05），P值具有显著性，为0.030。我们的研究为胶质瘤和转移瘤的细胞成分及pH值提供了新的见解，并且在区分这两者方面结果具有显著性。然而，由于额外的高昂费用，在印度只有极少数机构将其作为一种研究工具使用。
