论文部分内容阅读
目的探讨磁共振波谱(1H MRS)在良、恶性脑膜瘤鉴别诊断中的价值。方法经手术病理证实的36例脑膜瘤在治疗前行常规MRI及1H MRS检查(脑膜瘤Ⅰ级30例,Ⅱ+Ⅲ级6例)。1H MRS检查包括PRESS 35、PRESS 144序列。结果良性脑膜瘤组Cho/Cr比值(3.80±1.08);恶性脑膜瘤组Cho/Cr比值(7.22±0.70)。差异具有显著性(t=7.40,P=0.000)。MRS表现:本组脑膜瘤病例均未测得NAA,可见Cho峰升高、Cr降低。35例可测得特异的Ala峰。36例均测得谷氨酸和谷胺酰胺(Glx)峰。5例恶性脑膜瘤于1.3 ppm处见特异的Lip的亚甲基信号,而良性脑膜瘤中仅有1例纤维细胞型见Lip的亚甲基信号显示。结论脑膜瘤磁共振波谱Cho/Cr比值对脑膜瘤良、恶性鉴别诊断具有重要价值。1.3 ppm处Lip的亚甲基信号多提示为恶性脑膜瘤可能。
Objective To investigate the value of magnetic resonance spectroscopy (1H MRS) in the differential diagnosis of benign and malignant meningioma. Methods Thirty - six cases of meningioma proved by operation and pathology were examined by conventional MRI and 1H MRS before operation (meningioma grade Ⅰ 30, grade Ⅱ + Ⅲ 6). 1H MRS exams include PRESS 35, PRESS 144 sequences. Results Cho / Cr ratio (3.80 ± 1.08) in benign meningioma group and Cho / Cr ratio (7.22 ± 0.70) in malignant meningioma group. The difference was significant (t = 7.40, P = 0.000). MRS performance: NAA were not detected in this group of meningioma cases, Cho peak can be seen increased, Cr decreased. 35 cases can detect specific Ala peak. 36 cases were measured glutamate and glutamine (Glx) peak. Five malignant meningiomas showed a specific Lipid methylene signal at 1.3 ppm, whereas in benign meningiomas only one fibroblast type was seen with the Lip methylene signal. Conclusions MR / Cho ratio of meningioma is of great value in differential diagnosis of benign and malignant meningioma. 1.3 ppm at the Lip’s methylene signal more tips for malignant meningioma.