Early metabolic changes in metastatic brain tumors after Gamma Knife radiosurgery: 1H-MRS study.
Early metabolic changes in metastatic brain tumors after Gamma Knife radiosurgery: 1H-MRS study.
复制标题
DOI：
10.1007/bf02484512
复制
发表时间：
2004-01-01
影响因子：
3.3
通讯作者：
Hori, Tomokatsu
中科院分区：
文献类型：
--
作者：
Chernov, Mikhail F;Hayashi, Motohiro;Hori, Tomokatsu
通过长回波（TR，2000 ms; TE，136 ms; 128-236次采集）体积选择性单体素质子磁共振波谱（MRS）评价伽玛刀放射外科治疗后转移性脑肿瘤的早期代谢变化。81例患者的85个脑转移瘤在治疗前和治疗后16- 18小时进行了调查。计算N-乙酰天冬氨酸（NAA）/肌酸（Cr）、磷酸胆碱/甘油磷酸胆碱（Cho）/Cr、NAA/Cho、乳酸（Lac）/Cr、移动的脂质（Lip）/Cr等标准代谢比值，并比较照射前后的值。治疗后第二天，在任何病例中均未发现任何肿瘤的体积变化。肿瘤质子MRS显示Cho/Cr（P < 0.001）和NAA/Cr（P < 0.01）比值明显降低。术前Cho/Cr比值较高（P < 0.001）和增强不均匀（P <0.01）的肿瘤，Cho/Cr比值的降低更为显著。NAA/Cr比值的降低主要取决于其治疗前值（P < 0.001）。所观察到的Cho/Cr比值的降低可能反映了增殖活性的抑制和早期凋亡细胞的丢失，而NAA/Cr的降低可能是由于辐射诱导的肿瘤周围脑组织神经元活性的调节。序列质子磁共振波谱是评价颅内肿瘤放射外科治疗后代谢变化的一种有价值的诊断工具。
Evaluation of early metabolic changes in metastatic brain tumors after Gamma Knife radiosurgery was performed by long-echo (TR, 2000ms; TE, 136ms; 128-236 acquisitions) volume-selected single-voxel proton magnetic resonance spectroscopy (MRS). Eighty-five brain metastases in 81 patients were investigated before treatment and 16-18h thereafter. Standard metabolic ratios, namely N-acetylaspartate (NAA)/creatine (Cr), phosphorylcholine/glycerophosphorylcholine (Cho)/Cr, NAA/Cho, lactate (Lac)/Cr, and mobile lipids (Lip)/Cr, were calculated, and comparison of their values before and after irradiation was done. No volumetric changes of any neoplasm were found in any case on the next day after treatment. At the same time, significant reduction of Cho/Cr (P < 0.001) and NAA/Cr (P < 0.01) ratios on the proton MRS of the tumor was disclosed. Reduction of Cho/Cr ratio was significantly more prominent in neoplasms with higher pretreatment Cho/Cr ratios (P < 0.001) and heterogeneous contrast enhancement (P < 0.01). Reduction of NAA/Cr ratio was predominantly determined by its pretreatment value (P < 0.001). The observed decrease of Cho/Cr ratio probably reflects inhibition of proliferative activity and early apoptotic cell loss, whereas reduction of NAA/Cr may result from radiation-induced modulation of neuronal activity in the peritumoral brain tissue. Serial proton MRS represents a valuable diagnostic tool for evaluation of metabolic changes in intracranial neoplasms after radiosurgical treatment.