龙源期刊?/p>
http://www.qikan.com.cn
3D
?/p>
ASL
结合
1H
?/p>
MRS
在常见脑肿瘤?/p>
前诊断中的临床应用研?/p>
作者:陈亚?/p>
柴梦?/p>
李娜
陆皓
吴为?/p>
陆玉?/p>
来源:《右江医学?/p>
2017
年第
06
?/p>
【摘要】目的探讨三维动脉自旋标记(
3D arterial spin labeling
?/p>
3D-ASL
)结合氢质子磁共
振波谱(
1H magnetic resonance spectroscopy
?/p>
1H-MRS
)成像在颅脑常见肿瘤诊断中的临床?/p>
用价值。方法选择经术后病理证实的
35
例肿瘤病例(其中
13
例胶质瘤?/p>
12
例脑膜瘤?/p>
10
?/p>
转移瘤),测量肿瘤在
3D-ASL
血流灌注图中最大肿瘤血流量?/p>
tumor blood flow
?/p>
TBF
)与?/p>
侧正常脑白质、脑灰质、肿瘤镜像区脑血流量?/p>
brain tumor flow
?/p>
CBF
),同时测量波谱图肿
瘤瘤核心及对侧正常脑实质感兴趣区的胆碱(
Cho
)?/p>
N-
乙酰天门冬氨酸(
NAA
)、肌?/p>
?/p>
Cr
)峰值及其比值,结合术后病理诊断进行分析。结果高级别胶质瘤与脑膜瘤、转移瘤灌注
值差异无统计学意义(
P>0.05
),低级别胶质瘤与其他肿瘤灌注值差异有统计学意义(
P
【关键词】三维动脉自旋标记;氢质子磁共振波谱;脑肿瘤
中图分类号:
R651.1
文献标识码:
ADOI
?/p>
10.3969/j.issn.1003-1383.2017.06.018
?/p>
Abstract
?/p>
ObjectiveTo explore the clinical value of 3D arterial spin labeling
?/p>
3D-ASL
?/p>
combined with 1H magnetic resonance spectroscopy
?/p>
1H-MRS
?/p>
in the diagnosis of common brain
tumors.Methods35 cases of tumors confirmed by postoperative pathology
?/p>
13 cases of glioma
?/p>
12
cases of meningioma
?/p>
and 10 cases of metastatic tumor
?/p>
were selected.Tumor blood flow
?/p>
TBF
?/p>
in
3D-ASL perfusion images and cerebral blood flow
?/p>
CBF
?/p>
in contralateral normal white matter
?/p>
gray matter and tumor mirror area were measured.At the same time
?/p>
cholinergic
?/p>
Cho
),
N-
acetylated aspartate
?/p>
NAA
),
creatine
?/p>
Cr
?/p>
peak and their ratios in the region of interest of the
tumor and the normal brain parenchyma on the contralateral side were measured.Combined with
postoperative pathological diagnosis
?/p>
the above-mentioned situations were analyzed.ResultsThere
was no statistically significant difference in the perfusion value of high grade glioma with
meningioma and metastatic tumor
?/p>
P>0.05
),
while there was statistically significant difference
between low grade glioma and other tumor perfusion values
?/p>
P
?/p>
Key words
?/p>
3D-ASL
?/p>
1H-MRS
?/p>
brain tumors
颅内最常见的三大类肿瘤是胶质瘤、脑膜瘤、转移瘤
[1]
,一般情况下,磁共振成像
?/p>
magnetic resonance imaging
?/p>
MRI
)结合相关临床病史,可初步诊断,但当影像图像不典?/p>
或临床表现不支持时,
MRI
序列对脑肿瘤的鉴别诊断存在缺陷。近年来
MRI
多种新技术因?/p>
各自独特优势,应用不断推广,如三维动脉自旋标记(
3D arterial spin labeling
?/p>
3D-ASL
)可?/p>
创反映肿瘤病变中新生血管的微循环灌注信?/p>
[2]
,而氢质子磁共振波谱(
1H magnetic