Combination of single-voxel proton MR spectroscopy and apparent diffusion coefficient calculation in the evaluation of common brain tumors.
Combination of single-voxel proton MR spectroscopy and apparent diffusion coefficient calculation in the evaluation of common brain tumors.
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发表时间：
2003-02
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通讯作者：
N. Bulakbaşı;M. Kocaoglu;F. Ors;C. Tayfun;T. Uçöz
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作者：
N. Bulakbaşı;M. Kocaoglu;F. Ors;C. Tayfun;T. Uçöz
在过去的十年中，磁共振光谱和表观扩散系数（ADC）计算被频繁地用于肿瘤的分级和分化。我们评估这两种技术的结合是否可以提高磁共振成像对脑肿瘤患者的诊断效率。方法对49例经组织学证实的脑肿瘤患者（8例高级别和12例低级别星形细胞瘤、8例转移瘤、8例非星形细胞胶质瘤、7例脑膜瘤、3例胚胎发育异常神经上皮肿瘤（DNETs）和3例结核瘤）进行术前对比材料增强磁共振成像、单体素质子磁共振光谱（TE = 135 ms）和弥散加权成像（b = 0、500和1000 s/mm(2)）的前瞻性评估。结果磁共振光谱可以区分良恶性肿瘤，但不能用于恶性肿瘤的分级。在良恶性肿瘤鉴别中，n -乙酰天冬氨酸(NAA)/胆碱（Cho）、NAA/Cho +肌酸（Cr）、乳酸/Cr、丙氨酸/Cr比值（P < 0.001）高于NAA/Cr、乳酸/脂质比值（P < 0.05）。脂质/铬比和丙氨酸/铬比的升高可以区分转移瘤和脑膜瘤与其他肿瘤（P < 0.001）。DNETs可通过其正常光谱和高ADC值(116.25 +/- 6.93 × 10（-3) mm(2)/s）诊断。乳酸/铬比值升高与恶性程度相关（r = -0.71）。adc对恶性肿瘤分级有效（P < 0.001），但对同一分级不同类型肿瘤的区分无效。高度恶性肿瘤(87.16 +/- 10.41 × 10（-3) mm(2)/s）的ADC值明显低于低度恶性肿瘤(115.33 +/- 11.67 × 10（-3) mm(2)/s）和良性肿瘤(107.69 +/- 8.05 × 10（-3) mm(2)/s）。低级别星形细胞瘤瘤周adc明显高于高级别星形细胞瘤（P < 0.05）。结论肿瘤核心计算的ADC值与MR光谱获得的特异性相对代谢物比值相结合，可以为脑肿瘤的鉴别和分级提供更多的信息，两者结合使用比单独使用更有用。
BACKGROUND AND PURPOSE MR spectroscopy and apparent diffusion coefficient (ADC) calculation have been used frequently for tumor grading and differentiation during the last decade. We evaluated whether the combination of these two techniques can improve the diagnostic effectiveness of MR imaging in patients with brain tumors. METHODS Forty-nine patients with histologically proved brain tumors (eight high- and 12 low-grade astrocytomas, eight metastases, eight nonastrocytic gliomas, seven meningiomas, three dysembryoplastic neuroepithelial tumors (DNETs), and three tuberculomas) were prospectively evaluated with contrast material-enhanced MR imaging, single-voxel proton MR spectroscopy (TE = 135 ms), and diffusion-weighted imaging (b = 0, 500, and 1000 s/mm(2)) before surgery. RESULTS MR spectroscopy could differentiate benign from malignant tumors but was not useful in grading malignant tumors. In the differentiation of malignant from benign tumors, N-acetylaspartate (NAA)/choline (Cho), NAA/Cho + creatine (Cr), lactate/Cr, and alanin/Cr ratios (P <.001) were statistically more significant than NAA/Cr and lactate/lipid ratios (P <.05). Increase in lipid/Cr and alanin/Cr ratios could distinguish metastasis and meningiomas from other tumors, respectively (P <.001). DNETs could be diagnosed by their normal spectra and high ADC values (116.25 +/- 6.93 x 10(-3) mm(2)/s). Increase in lactate/Cr ratio correlated with degree of malignancy (r = -0.71). ADCs were effective for grading malignant tumors (P <.001) but not for distinguishing different tumor types with the same grade. High-grade malignant tumors (87.16 +/- 10.41 x 10(-3) mm(2)/s) had significantly lower ADC values than did low-grade malignant (115.33 +/- 11.67 x 10(-3) mm(2)/s) and benign (107.69 +/- 8.05 x 10(-3) mm(2)/s) tumors. Peritumoral ADCs were significantly higher in low-grade than in high-grade astrocytomas (P <.05). CONCLUSION Combination of calculated ADC values from tumoral core and specific relative metabolite ratios acquired by MR spectroscopy added more information to MR imaging in the differentiation and grading of brain tumors and were more useful together than each alone.