摘要
目的:探讨弥散张量成像(DTI)及氢质子磁共振波谱(1H-MRS)在脑胶质瘤诊断分级中的应用价值。方法:选取45例脑胶质瘤患者,分别进行DTI和~1H-MRS扫描检查,将~1H-MRS原始图像导入工作站,通过计算分别获得[胆碱(Cho)/N-乙酰天门冬氨酸(NAA),Cho/NAA]、[NAA/肌酸(Cr),NAA/Cr]及Cho/Cr数值。将弥散加权成像(DWI)图像导入工作站,自动计算出表观弥散系数(ADC)值和各向异性分数(FA)值;比较DTI及~1H-MRS检查瘤体区与对侧正常脑白质、低级别和高级别脑胶质瘤的FA值、ADC值、NAA/Cr和NAA/Cho参数,以及鉴别脑胶质瘤级别的诊断灵敏度和特异度。结果:瘤体区FA值、ADC值、NAA/Cr和NAA/Cho分别为(0.15±0.05)和(1.65±0.15)×10-3 mm^2/s、(0.65±0.13)和(0.52±0.12),明显低于对侧正常脑白质(t=-13.485,t=-12.005,t=-31.622,t=-29.207;P<0.05),而Cho/Cr为(2.84±0.44),明显高于对侧正常脑白质(t=30.903,P<0.05);低级别脑胶质瘤FA值、ADC值、NAA/Cr和NAA/Cho分别为(0.10±0.09)、(1.70±0.13)×10-3 mm^2/s、(0.88±0.20)和(0.67±0.20),明显高于高级别脑胶质瘤(t=4.077,t=3.978,t=6.179,t=3.283;P<0.05),而Cho/Cr为(2.52±0.54),明显低于高级别脑胶质瘤(t=-2.115,P<0.05)。DTI参数FA值鉴别脑胶质瘤级别的诊断灵敏度和特异度分别为90.00%和60.00%;1H-MRS参数NAA/Cho鉴别脑胶质瘤级别的诊断灵敏度和特异度分别为85.00%和96.00%。结论:DTI及1H-MRS在脑胶质瘤诊断分级中有较好的应用价值,其中FA和NAA/Cho鉴别价值极高。
Objective:To discuss the application value of diffusion tensor imaging(DTI)and magnetic resonance hydrogen proton spectroscopy(1H-MRS)in the diagnosis and classification of brain glioma.Methods:45 patients with brain glioma were implemented DTI and 1H-MRS scan,respectively.The original 1H-MRS image was imported into the workstation,and then Cho/NAA,NAA/Cr and Cho/Cr were respectively obtained through calculation.After the diffusion weighted imaging(DWI)were imported into the workstation,the apparent diffusion coefficient(ADC)and fractional anisotropy(FA)values could be calculated automatically.The results of parameters included FA,ADC,NAA/Cr and NAA/Cho of tumor area and contralateral normal white matter,and low-grade and high-grade brain gliomas between DTI and 1H-MRS were compared.And the diagnostic sensitivity and specificity of identifying brain glioma grade between the two methods also further were compared.Results:The FA value,ADC value,NAA/Cr and NAA/Cho of tumor area were(0.15±0.05),(1.65±0.15)×10^-3mm^2/s,(0.65±0.13)and(0.52±0.12),and they were significantly lower than that of contralateral normal white matter(t=-13.485,t=-12.005,t=-31.622,t=-29.207,P<0.05),respectively.And Cho/Cr of tumor area(2.84±0.44)was significantly higher than that of contralateral normal white matter(t=30.903,P<0.05).And the results of FA,ADC,NAA/Cr and NAA/Cho of low grade brain gliomas[(0.10±0.09),(1.70±0.13)×10^-3mm^2/s,(0.88±0.20)and(0.67±0.20)]were significantly higher than that of high-grade brain gliomas(t=4.077,t=3.978,t=6.179,t=3.283,P<0.05),respectively,while Cho/Cr of low-grade brain gliomas(2.52±0.54)was significantly less than that of high-grade brain gliomas(t=-2.115,P<0.05).In addition,the diagnostic sensitivity and specificity of FA value of DTI parameter in identifying brain glioma grade were 90.00%and 60.00%,respectively.While the diagnostic sensitivity and specificity of NAA/Cho of 1H-MRS parameter in identifying brain glioma grade were 85.00%and 96.00%,respectively.Conclusion:DTI and 1H-MRS have good application value in the diagnosis and classification of brain glioma,and the identification values of FA and NAA/Cho in these parameters are highest.
作者
何沛芝
黄文光
王金洪
国凤高
杨娟
李冰
青丽
HE Pei-zhi;HUANG Wen-guang;WANG Jin-hong(Department of Radiology,The First People’s Hospital of Guangyuan,Guangyuan 628017,China)
出处
《中国医学装备》
2018年第9期54-57,共4页
China Medical Equipment
关键词
弥散张量成像
氢质子磁共振波谱
脑胶质瘤
磁共振成像
Diffusion tensor imaging
1H-proton magnetic resonance spectroscopy
Brain glioma
Magnetic resonance imaging
作者简介
何沛芝,女,(1980-),本科学历,主治医师,从事头部MRI的临床研究与诊断工作。
