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1、中华现代影像学杂志JournalofChineseModernImaging2007年第4卷第9期·795··论著·磁共振氢质子波谱对颅脑肿瘤瘤周水肿的鉴别诊断价值△张金华,孟宪平,冯东侠,张怡璐,陆亚萍,姜歧涛,王旭[摘要]目的探讨氢质子磁共振波谱对颅脑肿瘤瘤周水肿鉴别诊断价值。方法对48例颅脑胶质瘤、转移瘤、脑膜1瘤及炎性肉芽肿性病变行常规MRI扫描和H2MRS检查,将距肿瘤强化外缘1cm以内区域划为近侧瘤周水肿区,1cm以外者为远侧瘤周水肿区,测各代谢物比值,即Cho/NAA、Cho/Cr、Cho/nCho。结果胶质瘤瘤周水肿Cho/NAA、Cho/
2、Cr、Cho/nCho增高,高级别胶质瘤其瘤周水肿值大于低级别胶质瘤、转移瘤、脑膜瘤及炎性肉芽肿病变周围水肿值(P<0105);高级别胶质1瘤近侧瘤周水肿值大于远侧瘤周水肿值(P<0101)。结论H2MRS可显示胶质瘤瘤周浸润,其近侧瘤周水肿区Cho/NAA、Cho/Cr、Cho/nCho有助于胶质瘤与其他肿瘤及病灶相鉴别,也有助于胶质瘤分级诊断。[关键词]脑肿瘤;瘤周水肿;氢质子波谱[中图分类号]R815[文献标识码]A[文章编号]1681-2824(2007)09-0795-05Valueofdifferentialdiagnosisonperitum
3、oraledemaofintracranialtumorwithprotonmagneticresonancespectroscopyZHANGJin2hua,MENGXian2ping,FENGDong2xia,etal.DepartmentofMRI,JiangyinPeople곰sHospitalofSouth2eastUniversity,Jiangyin214400,China1[Abstract]ObjectiveToevaluatethediagnosticvaluesofH2MRSinintracranialtumorsbyanalyzin
4、gthepa2rametersobtainedfromperitumoraledema.MethodsFortyeightpatientswithglioma,meningioma,metastasis,and1inflammatoryunderwentroutineMRIandH2MRS.ComparisonsofmetabolicratiosincludingCho/NAA,Cho/Cr,Cho/nChoweredonebetweenperitumoraledematousandthenormal.Theperitumoraledemawasdivid
5、edintotworegions:theimmediateperitumoraledemawasdefinedtobewithin1cmdistancefromtheouterenhancingtumormargin,andthedistantperitumoralonewasdefinedasgreaterthan1cmfromthetumor.ResultsGliomashowedabnormalspectraoutsidetheareaofcontrastenhancement,whichdemonstratedelevatedlevelofCho/
6、NAA,Cho/Cr,Cho/nCho.Themetabolicratiosinimmediateperitumoraledemaofpatientswithhigh2gradegliomawerehigherthanthoseinlow2gradeglioma,meningioma,metastasis,andinflammatorydiseases(P<0105).Themetabolicratiosofimmediateedemasurroundinghigh2gradegliomawerehigherthanthoseofdistantedema(
7、P<0101).Conclusion1H2MRScandemonstratetumorinfiltrationofglioma.ThemetabolicratiosofCho/NAA,Cho/Cr,Cho/nChoinimmediateperitumoraledemahavesignificanceinidentificationofhigh2gradegliomafromothertumors,andalsohavevalueingliomagradingdiagnosis.[Keywords]intracranialtumor;peritumorale
8、dema;protonmagneticresonancespect
