论文部分内容阅读
探讨磁共振成像( MRI) 和质子磁共振波谱(1 H MRS) 对脑膜瘤的诊断价值.材料和方法:364 例行常规MRI 检查, 其中15 例加做1 HMRS, 行肿瘤实质与健侧对应部位对照研究.结果: MRI 平扫示: T1 WI58 .0 %(211/364) 表现为等信号,32 .7 % (119/347) 为略低信号,9 .3 % (34/364) 为混合信号.T2 WI40 .1 % (139/347) 表现为等信号,42 .7 % (148/347) 表现为高信号,9 .5 % (33/347) 为略低信号,7 .8 % (27/347) 为混合信号.注射Gd - DTPA 后337 例肿瘤实质部分均有不同程度的强化.65 .9 % (222/337) 出现“脑膜尾征”.55 .5 % (202/364)可见不同程度的水肿.15 例1 H MRS 均表现为明显增高的胆碱(Cho) 峰,无氮乙酰门冬氨酸(NAA) 峰,Cho/Cr( 肌酸) 比值升高,NAA/Cr 及NAA/Cho 比值降低.4 例出现乳酸峰(Lac) .结论:MRI 平扫+ 增强是诊断脑膜瘤的最主要方法,1 H MRS 可作为很重要的补充.“,”Purpose:To evaluate the roles of MR imagimg and proton magnetic resonance spectroscopy (1H MRS) in the diagnosis of meningiomas. Materials and Methods:364 patients with meningiomas underwent conventional MRI.Among them,15cases had single voxel MR spectroscopy simultaneously both in the lesion's region and the contralateral side.Results:On pre-contrast MR images of 364 cases,T1WI showed 58.0%(211/364)isointensities,32.7%(119/364)faintly low intensities and 9.3%(34/364)mixed intensities.T2WI showed 40.1%(139/347)isointensities,42.7%(148/347)hyperintensities,9.5%(33/347)faintly low intensities and 7.8%(27/347)mixed intensities.After administration of Gd-DTPA,the solid part of the tumors exhibited various enhancement in all the 337 cases.“ Dural Tail sign ”was revealed in 222 of 337 cases (65.9%).Peritumoral edema was observed in 202 of 364 cases (54.9%).15 cases of MRS exhibited specific different spectral peaks including prominent choline-containing compounds (Cho), absent acetylaspartate(NAA)and decreased total creatine (Cr).4 cases showed abnormal lactate(Lac).The metabolic ratios showed significantly increased Cho/Cr,absent NAA/Cr and NAA/Cho.Conclusion:Conventional MRI is the most important dignostic means for meningiomas and MRS combined with MRI can improve diagnostic accuracy of meningiomas.