%0 Journal Article %T 氢质子磁共振波谱在胶质瘤术前分级中的应用价值 %A 刘娜 隋庆兰 赵继平 王家臣 段崇锋 牛蕾 刘学军 任延德 %J - %D 2019 %R 10.13362/j.jpmed.201901012 %X 摘要 目的 探讨氢质子磁共振波谱(1H-MRS)在胶质瘤术前分级中的应用价值。 方法 回顾性分析术前行1H-MRS检查、术后经病理组织学检查证实为胶质瘤的病人52例,其中高级别胶质瘤24例,低级别胶质瘤28例。采用GE 3.0T超导磁共振对肿瘤感兴趣区行多体素扫描计算代谢物比值变化,并通过受试者工作特征曲线(ROC曲线)确定高低级别胶质瘤各代谢物比值的阈值。 结果 高级别胶质瘤较低级别胶质瘤N-乙酰天门冬氨酸(NAA)/肌酸(Cr)比值明显下降(t=-2.814,P<0.01),胆碱(Cho)/Cr、Cho/NAA比值明显升高(t=2.454、2.671,P<0.05)。Cho/Cr、Cho/NAA、NAA/Cr各ROC曲线下面积(AUC)分别为0.696、0.729和0.708,分别计算出鉴别高低级别胶质瘤Cho/Cr比值的最佳诊断阈值为2.51,诊断灵敏度为57.1%,诊断特异度为83.3%;Cho/NAA比值的最佳诊断阈值为3.68,诊断灵敏度为71.4%,诊断特异度为75.0%;NAA/Cr比值的最佳诊断阈值为0.60,诊断灵敏度及特异度均为75.0%。 结论 1H-MRS在胶质瘤的术前分级中有一定价值。
Abstract:Objective To investigate the practical value of hydrogen proton magnetic resonance spectroscopy (1H-MRS) in the preoperative grading of gliomas. Methods A retrospective analysis was conducted for 52 patients with gliomas (28 low-grade gliomas and 24 high-grade gliomas) who had undergone a preoperative 1H-MRS examination and had been confirmed as gliomas by a postoperative histopathological examination. Multi-voxel magnetic resonance spectroscopy with a GE 3.0 T superconductive magnet was performed to calculate the changes in metabolite ratios in the region of interest of tumor, and the thresholds of metabolite ratios between high-grade gliomas and low-grade gliomas were determined by a receiver operating characteristic (ROC) curve. Results Compared with low-grade gliomas, high-grade gliomas showed a significantly reduced ratio of N-acetylaspartate (NAA)/creatinine (Cr) (t=-2.814,P<0.01) and significantly increased ratios of choline (Cho)/Cr and Cho/NAA (t=2.454,2.671,P<0.05). The areas under the ROC curves of Cho/Cr, Cho/NAA, and NAA/Cr were 0.696, 0.729, and 0.708, respectively. The optimal diagnostic threshold, diagnostic sensitivity, and diagnostic specificity for differentiating high-grade gliomas from low-grade gliomas were 2.51,57.1%, and 83.3%, respectively, when taking Cho/Cr as the standard, were 3.68, 71.4%, and 75.0%, respectively, when taking Cho/NAA as the standard, and were 0.60,75.0%, and 75.0%, respectively, when taking NAA/Cr as the standard. Conclusion 1H-MRS shows some value in the preoperative grading of gliomas %K 神经胶质瘤 %K 质子磁共振光谱法 %K 肿瘤分级
Glioma %K Proton magnetic resonance spectroscopy %K Neoplasm grading %U http://jpmed.qdu.edu.cn/CN/10.13362/j.jpmed.201901012