Grading of diffuse astrocytomas with in vivo 1H MR spectroscopy, perfusion and diffusion imaging
- Author:
- No author available
- Journal Title:
- CHINESE JOURNAL OF RADIOLOGY
- Issue:
- 2
- DOI:
- 10.3760/j.issn:1005-1201.2007.02.013
- Key Word:
- 星形细胞瘤;磁共振波谱学;扩散;分级
Abstract： 目的 探讨活体1H MR波谱(MRS)、脑灌注成像(PI)及扩散成像(DWI)对弥漫性星形细胞肿瘤的分级价值.方法 搜集经手术病理证实的弥漫性星形细胞肿瘤154例.按世界卫生组织分级:星形细胞瘤(Ⅱ级),问变型星形细胞瘤(Ⅲ级)以及胶质母细胞瘤(Ⅳ级).35例行1H MRS检查,其中Ⅱ级8例,Ⅲ级13例,Ⅳ级14例,比较各级肿瘤之间胆碱/肌酸(Cho/Cr)、N-乙酰天冬氨酸(NAA)/Cr及乳酸(Lac)/Cr值;76例应用MR平面回波成像技术(EPI)行对比剂增强灌注成像(CE PI),包括Ⅱ级36例,Ⅲ级20例,Ⅳ级20例,比较各级别星形细胞瘤内最大相对局部脑血容量(rrCBV);43例行DWI,其中Ⅱ级26例,Ⅲ级6例,Ⅳ级11例,比较各级别肿瘤间的表观扩散系数比率(ADCR).结果 1H MRS组中Ⅱ、Ⅲ、Ⅳ级星形细胞瘤的Cho/Cr分别为2.709±1.228,5.812±2.374及5.289±1.462,3组之间差异有统计学意义(P＜0.05).Ⅱ、Ⅲ、Ⅳ级星形细胞瘤的Lac/Cr分别为0.100±0.083、1.879±1.595及3.656±2.195,3组之间差异均有统计学意义(P＜0.01).Ⅱ、Ⅲ、Ⅳ级星形细胞肿瘤的NAA/Cr之间差异无统计学意义(P＞0.05);动态CE PIⅡ级与Ⅲ、Ⅳ级的rrCBV分别为1.379±0.739、2.654±1.072、3.218±1.565,3组差异有统计学意义(P＜0.01).rrCBV与弥漫性星形细胞肿瘤的分级呈正相关(rs=0.601,P＜0.01).rrCBV区分Ⅰ～Ⅱ级与Ⅲ～Ⅳ级的界值点为1.898(敏感性85.0%,特异性88.9%);DWI组中Ⅱ级与Ⅲ+Ⅳ级的ADCR差异无统计学意义(t=1.846,P=0.072).结论 活体1H MRS能反映不同级别星形细胞肿瘤的代谢差别;动态CE MRI可以揭示肿瘤内血管分布状况,量化病变的血管生成,为临床提供病生理学信息.依此可对弥漫性星形细胞肿瘤进行分级.
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