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目的探讨利用磁共振波谱成像(MRSI)反映胶质瘤恶性度的价值。方法41例病理证实胶质瘤,原发39例、复发2例,行MR及MRS扫描,MRS数据经残差Z分数统计模型及LLI、L ip/Cho等指标划分肿瘤边界及不同代谢区,并结合MR I结构成像,划分出肿瘤的高代谢活性区、肿瘤浸润边界、坏死区及乏氧区。结果肿瘤浸润边界均超过MR常规图像上的肿瘤边界。Ⅱ级肿瘤高代谢活性区大部分位于肿瘤区内,但Ⅲ、Ⅳ级则大部分位于肿瘤边界;随肿瘤恶性度升高,肿瘤出现了坏死区及乏氧区。结论MRSI对确定肿瘤恶性度及划分肿瘤边界具有一定价值。
Objective To investigate the value of using magnetic resonance spectroscopy (MRSI) to reflect the malignancy of gliomas. Methods Forty-one patients were pathologically confirmed gliomas, 39 cases were primary and 2 cases were relapsed. MR and MRS scans were performed. The MRS data were analyzed by residual Z-score model and LLI, LpI / Cho and other indicators to separate the tumor border and different metabolic regions. Combined with MR I structure imaging, the tumor was divided into high metabolic activity area, tumor infiltration boundary, necrosis area and hypoxia area. Results The tumor infiltration margin surpassed the tumor border on MR conventional imaging. Most of grade Ⅱ tumors were located in the tumor area with high metabolic activity, but most of them were located at the tumor boundary in grade Ⅲ and Ⅳ. With the increase of malignancy, the tumor showed necrosis and hypoxia area. Conclusion MRSI has certain value in determining the degree of tumor malignancy and dividing the tumor boundary.