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目的探讨磁敏感加权成像(SWI)及波谱成像(MRS)在脑高、低级别星形细胞瘤鉴别诊断中的价值。资料与方法搜集2009年12月至2011年1月37例经手术病理证实的星形细胞瘤患者的MRI资料,所有患者术前均应用Siemens Verio 3.0 T超导磁共振仪行常规MRI平扫+增强、SWI和2D1H-MRS,并将各自结果同病理结果比较并统计分析,得出敏感度、特异度并同常规MRI比较。结果 (1)SWI序列中显示星形细胞瘤的出血率在高、低级别星形细胞瘤鉴别诊断中无显著性差异(P>0.05),而出血量在高、低级别星形细胞瘤鉴别诊断中有显著性差异(P<0.05)。(2)高、低级别星形细胞瘤瘤体代谢物胆碱(Cho)/N-乙酰天门冬氨酸(NAA)、Cho/肌酸(Cr)、NAA/Cr均有显著性差异(P<0.05)。(3)瘤体出血指数C值和Cho/NAA联合筛检,敏感度100%,特异度83.3%。结论 (1)同常规MRI比较,SWI能提高星形细胞瘤分级诊断的特异度,2D1H-MRS能提高星形细胞瘤分级诊断的准确度。(2)瘤体出血指数C值和Cho/NAA值联合筛检能提高星形细胞瘤分级诊断的敏感度。
Objective To investigate the value of magnetic susceptibility weighted imaging (SWI) and spectral imaging (MRS) in the differential diagnosis of high and low grade astrocytomas. Materials and Methods The MRI data of 37 patients with astrocytoma confirmed by surgery and pathology were collected from December 2009 to January 2011. All patients underwent MRI preoperatively with Siemens Verio 3.0 T superconducting magnetic resonance Enhanced, SWI and 2D1H-MRS, and their results compared with the pathological results and statistical analysis, the sensitivity, specificity and compared with conventional MRI. Results (1) The hemorrhage rate of astrocytomas in SWI showed no significant difference in the differential diagnosis between high and low grade astrocytoma (P> 0.05), while the amount of bleeding was identified in high and low grade astrocytoma There was a significant difference in diagnosis (P <0.05). (2) There were significant differences in the tumor metabolites Cho / NAs, Cho / Cr and NAA / Cr in high and low grade astrocytomas <0.05). (3) The combined hematoma index (C) and Cho / NAA screening showed a sensitivity of 100% and a specificity of 83.3%. Conclusion (1) Compared with the conventional MRI, SWI can improve the specificity of grade diagnosis of astrocytomas, and 2D1H-MRS can improve the accuracy of grade diagnosis of astrocytoma. (2) Combined screening of tumor hemorrhage index C and Cho / NAA can improve the sensitivity of staging diagnosis of astrocytoma.