Chang K H, Song I C, Kim S H, Han M H, Kim H D, Seong S O, Jung H W, Han M C
Department of Diagnostic Radiology, Seoul National University College of Medicine, Korea.
AJNR Am J Neuroradiol. 1998 Mar;19(3):401-5.
Our objective was to evaluate the proton MR spectroscopic pattern of the cystic contents of various intracranial masses and to report characteristic spectral patterns that may be helpful in the differential diagnosis of these lesions.
We evaluated 40 proton MR spectra obtained from cystic contents of various intracranial cystic masses in 39 patients, including gliomas (n = 14), metastases (n = 3), abscesses (n = 8), cysticercosis (n = 4), epidermoids (n = 3), and others (n = 7). Proton MR spectroscopy was performed on a 1.5-T MR unit using a point-resolved spectroscopic sequence with a 2 x 2 x 2 cm3 volume of interest. Assignment of the resonance peaks was based on previous studies.
Adequate proton MR spectroscopic data were obtained in 35 cases (88%). In most gliomas and metastases, only a lactate resonance was observed. There was a trend toward a higher lactate peak in high-grade gliomas. A few tumors, including malignant gliomas and metastases, showed lipid signal combined with lactate signal. In abscesses, there were various combinations of lactate, acetate, succinate, amino acids (including valine, alanine, and/or leucine), and/or unassigned resonances. In cysticercosis, resonances of lactate, succinate, alanine, acetate, and/or unassigned resonances were observed. Three epidermoid cysts showed only lactate signal. There were no identifiable resonances from the arachnoid and porencephalic cysts.
Only lactate is commonly observed in a variety of intracranial cystic masses, except for abscess and cysticercosis, in which resonances of acetate, succinate, amino acids, and/or unassigned metabolites can be seen in addition to a lactate peak.
我们的目的是评估各种颅内肿块囊性内容物的质子磁共振波谱模式，并报告可能有助于这些病变鉴别诊断的特征性波谱模式。
我们评估了39例患者各种颅内囊性肿块囊性内容物的40个质子磁共振波谱，包括胶质瘤（n = 14）、转移瘤（n = 3）、脓肿（n = 8）、囊尾蚴病（n = 4）、表皮样囊肿（n = 3）和其他（n = 7）。使用点分辨波谱序列在1.5-T磁共振设备上进行质子磁共振波谱分析，感兴趣体积为2×2×2 cm³。共振峰的归属基于先前的研究。
35例（88%）获得了足够的质子磁共振波谱数据。在大多数胶质瘤和转移瘤中，仅观察到乳酸共振峰。高级别胶质瘤中有乳酸峰升高的趋势。少数肿瘤，包括恶性胶质瘤和转移瘤，显示出脂质信号与乳酸信号并存。在脓肿中，存在乳酸、乙酸、琥珀酸、氨基酸（包括缬氨酸、丙氨酸和/或亮氨酸）和/或未归属共振峰的各种组合。在囊尾蚴病中，观察到乳酸、琥珀酸、丙氨酸、乙酸和/或未归属共振峰。三个表皮样囊肿仅显示乳酸信号。蛛网膜囊肿和脑穿通畸形囊肿未观察到可识别的共振峰。
除脓肿和囊尾蚴病外，在各种颅内囊性肿块中通常仅观察到乳酸，在脓肿和囊尾蚴病中，除乳酸峰外还可见乙酸、琥珀酸、氨基酸和/或未归属代谢物的共振峰。
