MRS在鉴别颅脑原发性肿瘤及转移瘤中的探讨(1)
摘 要：目的 探究颅脑原发性肿瘤与转移瘤鉴别中应用磁共振波谱的临床价值。方法 回顾性分析2012年1月～2018年5月在我院接受治療的颅脑原发性肿瘤患者32例以及颅脑转移瘤患者25例的临床资料，分别记为甲组与乙组，诊断时均行MRS检查，计算并比较两组Cho/Cr、NAA/Cr、Cho/NAA。结果 经MRS诊断，甲组Cho/Cr、Cho/NAA分别为(3.12±1.02)、(3.18±1.05)，乙组分别为(1.96±0.53)、(2.03±0.65)，甲组高于乙组，差异有统计学意义(P<0.05)，甲组NAA/Cr为(1.12±0.31)，乙组为(1.47±0.37)，甲组低于乙组，差异有统计学意义(P<0.05)。结论 颅脑原发性肿瘤与转移瘤实质区代谢物相对浓度存在较大差异，临床中可使用MRS诊断对其进行鉴别，协助诊断，为治疗提供科学依据。
关键词：磁共振波谱;颅脑原发性肿瘤;脑转移瘤
中图分类号：R739.41 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.24.039
, 百拇医药
文章编号：1006-1959(2018)24-0134-03
Abstract： Objective To explore the clinical value of magnetic resonance spectroscopy in differentiating primary brain tumor from metastatic tumor.Methods Analysis of 32 cases of primary brain tumor treated in our hospital from January 2012 to May 2018 and clinical data of 25 patients with craniocerebral metastases was made and they were recorded as group A and group B respectively.MRS examination was performed on diagnosis， and Cho/Cr，NAA/Cr，Cho/NAA were calculated and compared between the two groups.Results The Cho/Cr，Cho/NAA of group A was (3.12±1.02)， (3.18±1.05)， that of group B was (1.96±0.53)， (2.03±0.65)， group A was higher than group B， the difference was statistically significant (P<0.05).The NAA/Cr of group A was(1.12±0.31) and group B was(1.47±0.37)， respectively， group A was significantly lower than those of group B，the difference was statistically significant(P<0.05).Conclusion The relative concentrations of metabolites in the parenchymal regions of primary brain tumor and metastatic tumor are quite different. MRS diagnosis can be used to differentiate and assist in the diagnosis of primary brain tumor in order to provide scientific basis for treatment.
, 百拇医药
Key words：Magnetic resonance spectroscopy;Primary brain tumor;Brain metastases
颅脑原发性肿瘤(primary brain tumor)与脑转移瘤(brain metastases)是临床发病率较高的脑肿瘤，其中脑转移肿瘤占据肿瘤总数的1/5左右[1]。通常情况下，脑转移瘤是脑实质的多发病灶，并且部分患者具有其他部位原发恶性肿瘤病史，结合影像学检查能够确诊。MRI是鉴别两种肿瘤的重要手段，然而在多数情况下其图像特异性不足，特别是在转移瘤单发或原发性肿瘤多发但患者临床表现与病史无鉴别价值时，难以获取正确诊断结果。随着医学诊断技术的进步，磁共振波谱(Magneticresonancespectrum，MRS)应用范围不断拓宽，其是通过磁共振化学位移现象对物质分子成分进行测定的检测技术，可用于颅内肿瘤生化与代谢物变化的观察。由于大部分肿瘤病理波谱特征相似，临床上关于MRS是否能进一步鉴别存在一定争议。有国外学者指出，瘤周代谢物差异可能具有一定鉴别价值[2]。本研究通过对比两种肿瘤周围代谢物成分与变化，探究颅脑原发性肿瘤与转移瘤鉴别中MRS的临床价值，现报道如下。, http://www.100md.com(祝龙 罗小平 胡凌 王武华 洪欣)
关键词：磁共振波谱;颅脑原发性肿瘤;脑转移瘤
中图分类号：R739.41 文献标识码：B DOI：10.3969/j.issn.1006-1959.2018.24.039
, 百拇医药
文章编号：1006-1959(2018)24-0134-03
Abstract： Objective To explore the clinical value of magnetic resonance spectroscopy in differentiating primary brain tumor from metastatic tumor.Methods Analysis of 32 cases of primary brain tumor treated in our hospital from January 2012 to May 2018 and clinical data of 25 patients with craniocerebral metastases was made and they were recorded as group A and group B respectively.MRS examination was performed on diagnosis， and Cho/Cr，NAA/Cr，Cho/NAA were calculated and compared between the two groups.Results The Cho/Cr，Cho/NAA of group A was (3.12±1.02)， (3.18±1.05)， that of group B was (1.96±0.53)， (2.03±0.65)， group A was higher than group B， the difference was statistically significant (P<0.05).The NAA/Cr of group A was(1.12±0.31) and group B was(1.47±0.37)， respectively， group A was significantly lower than those of group B，the difference was statistically significant(P<0.05).Conclusion The relative concentrations of metabolites in the parenchymal regions of primary brain tumor and metastatic tumor are quite different. MRS diagnosis can be used to differentiate and assist in the diagnosis of primary brain tumor in order to provide scientific basis for treatment.
, 百拇医药
Key words：Magnetic resonance spectroscopy;Primary brain tumor;Brain metastases
颅脑原发性肿瘤(primary brain tumor)与脑转移瘤(brain metastases)是临床发病率较高的脑肿瘤，其中脑转移肿瘤占据肿瘤总数的1/5左右[1]。通常情况下，脑转移瘤是脑实质的多发病灶，并且部分患者具有其他部位原发恶性肿瘤病史，结合影像学检查能够确诊。MRI是鉴别两种肿瘤的重要手段，然而在多数情况下其图像特异性不足，特别是在转移瘤单发或原发性肿瘤多发但患者临床表现与病史无鉴别价值时，难以获取正确诊断结果。随着医学诊断技术的进步，磁共振波谱(Magneticresonancespectrum，MRS)应用范围不断拓宽，其是通过磁共振化学位移现象对物质分子成分进行测定的检测技术，可用于颅内肿瘤生化与代谢物变化的观察。由于大部分肿瘤病理波谱特征相似，临床上关于MRS是否能进一步鉴别存在一定争议。有国外学者指出，瘤周代谢物差异可能具有一定鉴别价值[2]。本研究通过对比两种肿瘤周围代谢物成分与变化，探究颅脑原发性肿瘤与转移瘤鉴别中MRS的临床价值，现报道如下。, http://www.100md.com(祝龙 罗小平 胡凌 王武华 洪欣)