Meyerand M E, Pipas J M, Mamourian A, Tosteson T D, Dunn J F
Department of Diagnostic Radiology, Biomedical NMR Research Lab, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Hanover, NH, USA.
AJNR Am J Neuroradiol. 1999 Jan;20(1):117-23.
Our purpose was to develop a classification scheme and method of presentation of in vivo single-voxel proton spectroscopic data from astrocytomas that most closely match the classification scheme determined from biopsy specimens. Since in vivo proton spectroscopy is noninvasive, it may be an attractive alternative to intracranial biopsy.
Single-voxel spectra were acquired using the point-resolved spectroscopic pulse sequence as part of the Probe spectroscopy package on a G.E. 1.5-T Signa scanner. Subjects consisted of 27 patients with biopsy-confirmed brain tumors (13 with glioblastoma multiforme, six with anaplastic astrocytoma, and eight with low-grade astrocytoma). The patients were divided into groups based on the histologic subtype of their tumor for different treatment protocols.
Metabolic peak areas were normalized for each metabolite (choline, creatine, N-acetylaspartate, lactate) to the area of the unsuppressed water peak and to the area of the creatine peak. Kruskal-Wallis nonparametric analysis of variance (ANOVA) tests showed statistically significant differences among the tumor groups for all the area ratios. The lactate/water ratio could be used to distinguished all three tumor groups, whereas the choline/water ratio distinguished low-grade astrocytomas from the two high-grade groups. Both the choline and lactate ratios could be used to separate the high-grade from the low-grade tumors.
Specific relative metabolic peak area ratios acquired from regions of contrast-enhancing brain tumor can be used to classify astrocytomas as to histopathologic grade.
我们的目的是制定一种分类方案以及呈现来自星形细胞瘤的体内单体素质子光谱数据的方法，使其与通过活检标本确定的分类方案最为接近。由于体内质子光谱检查是无创的，它可能是颅内活检的一种有吸引力的替代方法。
使用点分辨光谱脉冲序列获取单体素质谱，该序列是通用电气1.5-T Signa扫描仪上Probe光谱软件包的一部分。研究对象包括27例经活检确诊为脑肿瘤的患者（13例多形性胶质母细胞瘤、6例间变性星形细胞瘤和8例低级别星形细胞瘤）。根据肿瘤的组织学亚型将患者分为不同治疗方案的组。
将每种代谢物（胆碱、肌酸、N-乙酰天门冬氨酸、乳酸）的代谢峰面积相对于未抑制水峰面积和肌酸峰面积进行归一化。Kruskal-Wallis非参数方差分析（ANOVA）测试表明，所有面积比在肿瘤组之间存在统计学上的显著差异。乳酸/水比值可用于区分所有三个肿瘤组，而胆碱/水比值可将低级别星形细胞瘤与两个高级别组区分开来。胆碱和乳酸比值均可用于将高级别肿瘤与低级别肿瘤区分开来。
从增强扫描的脑肿瘤区域获取的特定相对代谢峰面积比可用于将星形细胞瘤按组织病理学分级进行分类。
