Sutton L N, Wehrli S L, Gennarelli L, Wang Z, Zimmerman R, Bonner K, Rorke L B
Children's Hospital of Philadelphia, Pennsylvania.
J Neurosurg. 1994 Sep;81(3):443-8. doi: 10.3171/jns.1994.81.3.0443.
High-resolution proton magnetic resonance (MR) spectroscopy was performed on perchlorate extracts of tumors (24 cases) or peritumoral vermis (five cases) obtained at surgery. Fifteen tumors were typical cerebellar astrocytomas and nine were posterior fossa primitive neuroectodermal tumors/medulloblastomas. Spectra obtained from the five samples of peritumoral vermis revealed a pattern of metabolites similar to that reported for cerebellar tissue, but concentrations of most metabolites were low, perhaps due to dilution from peritumoral edema. The astrocytomas were characterized by high levels of valine, alanine, and choline, an increase in the choline:N-acetylaspartate (NAA) ratio, and a shift from glutamate to glutamine. Elevations in lactate, pyruvate, and glucose were the result of ischemia during sampling. The primitive neuroectodermal tumors/medulloblastomas were distinguished from astrocytomas by a greater increase in the choline:NAA ratio, a smaller decrease in the glutamate:glutamine ratio, and a relative increase in glycine, taurine, and inositol levels. These metabolic patterns may be of value diagnostically as in vivo MR spectroscopy achieves higher resolution.
对手术获取的肿瘤（24例）或肿瘤周围小脑蚓部组织（5例）的高氯酸盐提取物进行了高分辨率质子磁共振（MR）波谱分析。15例肿瘤为典型的小脑星形细胞瘤，9例为后颅窝原始神经外胚层肿瘤/髓母细胞瘤。从5例肿瘤周围小脑蚓部组织样本获得的波谱显示，其代谢物模式与报道的小脑组织相似，但大多数代谢物的浓度较低，这可能是由于肿瘤周围水肿的稀释作用。星形细胞瘤的特征是缬氨酸、丙氨酸和胆碱水平较高，胆碱与N-乙酰天门冬氨酸（NAA）的比值增加，以及从谷氨酸向谷氨酰胺的转变。乳酸、丙酮酸和葡萄糖水平升高是采样期间缺血的结果。原始神经外胚层肿瘤/髓母细胞瘤与星形细胞瘤的区别在于，胆碱与NAA的比值增加幅度更大，谷氨酸与谷氨酰胺的比值下降幅度更小，以及甘氨酸、牛磺酸和肌醇水平相对增加。随着体内MR波谱实现更高分辨率，这些代谢模式在诊断上可能具有价值。
