Sijens P E, Levendag P C, Vecht C J, van Dijk P, Oudkerk M
Department of Radiology, Dr Daniel den Hoed Cancer Center (DDHCC), University Hospital Rotterdam, The Netherlands.
NMR Biomed. 1996 Apr;9(2):65-71. doi: 10.1002/(SICI)1099-1492(199604)9:2<65::AID-NBM397>3.0.CO;2-N.
1H MR spectroscopy was used to correlate the metabolite signals in 66 untreated metastatic brain tumors with the results of Gd-DTPA enhanced MRI. Cubic volumes containing brain metastases of lung cancer (n = 17), mammary carcinoma (n = 24), melanoma (n = 12) and those originating from other tumors (n = 13) were examined using the double spin echo technique with CHESS pulses for water suppression and TE = 135 ms. Apart from trends toward reduced signals of choline-containing compounds (Cho) and reduced post-Gd MRI contrast in lung cancer compared with the other pathology groups, the four tumor groups had similar MRI and MRS characteristics. Metastases without lipid or lactate (Lact) signal in the 1H MR spectra were comparatively small in size with homogeneous post-Gd MRI enhancement (33 +/- 5%, means +/- SEM; n = 24) and elevated Cho signals compared with normal contralateral brain tissue (70 +/- 5% of contralateral N-acetyl aspartate signal; p < 0.001). The other metastases showed either unambiguous lipid signals (n = 30) or MRS detectable Lact (n = 12) and were heterogeneous on MRI with divergent signals of Gd-enhancement (49 +/- 5% vs 14 +/- 8%, p < 0.001) and Cho (88 +/- 10 vs 47 +/- 8% of contralateral NAA; p = 0.02). Those with Lact were significantly larger compared with both other groups (p < 0.02, both). It is concluded that brain metastases can be categorized into early stage (Cho), intermediate stage (lipid, higher Cho) and late stage metastases (Lact, lower Cho).
采用1H磁共振波谱技术，将66例未经治疗的转移性脑肿瘤中的代谢物信号与钆喷酸葡胺增强磁共振成像（Gd-DTPA enhanced MRI）结果进行关联分析。使用双自旋回波技术及CHESS脉冲进行水抑制，回波时间（TE）=135 ms，对包含肺癌脑转移瘤（n = 17）、乳腺癌脑转移瘤（n = 24）、黑色素瘤脑转移瘤（n = 12）以及其他肿瘤来源的脑转移瘤（n = 13）的立方体积区域进行检查。除肺癌组与其他病理组相比，含胆碱化合物（Cho）信号有降低趋势以及钆增强磁共振成像对比度降低外，这四个肿瘤组具有相似的磁共振成像（MRI）和磁共振波谱（MRS）特征。1H磁共振波谱中无脂质或乳酸（Lact）信号的转移瘤，其大小相对较小，钆增强磁共振成像表现为均匀强化（33±5%，均值±标准误；n = 24），与对侧正常脑组织相比，Cho信号升高（为对侧N-乙酰天门冬氨酸信号的70±5%；p < 0.001）。其他转移瘤则表现为明确的脂质信号（n = 30）或磁共振波谱可检测到的Lact（n = 12），磁共振成像表现为不均匀强化，钆增强信号差异较大（49±5%对14±8%，p < 0.001），Cho信号也有差异（为对侧NAA的88±10%对47±8%；p = 0.02）。有Lact信号的转移瘤与其他两组相比明显更大（p < 0.02，两者相比）。结论是脑转移瘤可分为早期（Cho）、中期（脂质、较高Cho）和晚期转移瘤（Lact、较低Cho）。
