【摘要】：目的:探討1H-MRS對(duì)腦低級(jí)別膠質(zhì)瘤與腦炎、腦梗死的鑒別診斷價(jià)值。 方法：使用飛利浦3.0T磁共振系統(tǒng)對(duì)66例患者(其中低級(jí)別膠質(zhì)瘤20例,腦炎26例,腦梗死20例)進(jìn)行常規(guī)MRI平掃和增強(qiáng)掃描,并在病灶區(qū)及相應(yīng)正常腦實(shí)質(zhì)區(qū)設(shè)置感興趣區(qū)進(jìn)行單體素氫質(zhì)子波譜成像。腦炎和腦梗死病例均為急性或亞急性期，均經(jīng)臨床治療后隨診證實(shí)，腦低級(jí)別膠質(zhì)瘤病例均經(jīng)手術(shù)/活檢病理證實(shí)。對(duì)三組患者的臨床、影像學(xué)資料分別進(jìn)行回顧性分析比較。利用Function Tool軟件對(duì)波譜數(shù)據(jù)進(jìn)行分析，，分別計(jì)算三組患者1H-MRS病灶側(cè)NAA/Cr、NAA/Cho、Cho/Cr、Cho/NAA以及正常區(qū)域相應(yīng)代謝物比值變化。采用SPSS16.0統(tǒng)計(jì)分析軟件對(duì)所得數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析。 結(jié)果： 1.低級(jí)別膠質(zhì)瘤、腦炎、腦梗死與相應(yīng)部位正常腦實(shí)質(zhì)區(qū)的Cho/Cr、NAA/Cho、NAA/Cho、NAA/Cr值均有統(tǒng)計(jì)學(xué)差異(P＜0.05) 2.腦低級(jí)別膠質(zhì)瘤與腦炎、腦梗死的Cho／Cr、Cho／NAA、NAA／Cho值之間的差別具有高度顯著性(P0.01)，而腦梗死的各項(xiàng)指標(biāo)與腦炎之間的差別無顯著性(P0.05) 3. Cho/Cr、Cho/NAA、NAA/Cr、NAA/Cho的ROC曲線下面積分別為0.852、0.915、0.258、0.093。其中Cho/Cr取界值為2.47時(shí)，鑒別腦低級(jí)別膠質(zhì)瘤和非腫瘤病變（腦炎、腦梗死）的靈敏度為93㳠，特異度為77.8㳠；Cho/NAA取界值為3.18時(shí)，鑒別腦低級(jí)別膠質(zhì)瘤和非腫瘤病變（腦炎、腦梗死）的靈敏度為93㳠，特異度為88.9㳠 結(jié)論： 1.Cho／Cr、Cho／NAA、NAA／Cho能鑒別腦低級(jí)膠質(zhì)瘤與腦梗死、腦炎。 2.腦炎與腦梗死比較，各項(xiàng)指標(biāo)均無鑒別診斷價(jià)值。 3.MRS的量化指標(biāo)Cho／Cr、Cho／NAA對(duì)鑒別診斷腦低級(jí)膠質(zhì)瘤與腦梗死、腦炎有一定參考價(jià)值。
[Abstract]:Objective: to investigate the value of 1H-MRS in the differential diagnosis of low grade gliomas from encephalitis and cerebral infarction. Methods: a total of 66 patients (20 cases of low grade glioma, 26 cases of encephalitis and 20 cases of cerebral infarction) underwent conventional MRI plain scan and enhanced scanning with Philips 3.0T magnetic resonance system. The region of interest was set up in the focus area and the corresponding normal brain parenchyma area. The cases of encephalitis and cerebral infarction were both acute or subacute, which were confirmed by follow up after clinical treatment, and those with low grade gliomas were confirmed by operation / biopsy. The clinical and imaging data of the three groups were retrospectively analyzed and compared. The spectral data were analyzed by Function Tool software, and the changes of the ratio of metabolites in the lesion side of 1H-MRS and the corresponding metabolites in the normal region were calculated in three groups of patients. SPSS16.0 statistical analysis software was used to analyze the data. Results: 1. The Cho/Cr,NAA/Cho,NAA/Cr values of low grade glioma, encephalitis, cerebral infarction and normal cerebral parenchyma were significantly different (P < 0. 05) 2. The difference of Cho/Cr,Cho/NAA,NAA/Cho between low grade glioma and encephalitis and cerebral infarction was significant (P0. 01), but there was no significant difference between the indexes of cerebral infarction and encephalitis (P0.05). The area under the ROC curve of Cho/Cr,Cho/NAA,NAA/Cr,NAA/Cho is 0.852O0.915U 0.258N 0.093, respectively. When the threshold of Cho/Cr is 2.47, the sensitivity of differentiating low-grade gliomas from non-neoplastic lesions (encephalitis, cerebral infarction) is 93U, the specificity is 77.8%, and the threshold value of Cho/Cr / NAA is 3.18, and the difference between low-grade gliomas and non-tumor lesions (encephalitis) is 3.18. The sensitivity and specificity of cerebral infarction were 93? Conclusion: 1. Chor / Cro / NAA / Cho can distinguish low grade glioma from cerebral infarction and encephalitis. 2. Compared with cerebral infarction, there is no value in differential diagnosis of encephalitis and cerebral infarction. Cho/Cr,Cho/NAA, a quantitative index of 3.MRS, has certain reference value in differential diagnosis of cerebral glioma and cerebral infarction and encephalitis.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R739.41;R512.3;R743.3

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相關(guān)期刊論文 前1條

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