上海交通大学学报（医学版）

›› 2009, Vol. 29 ›› Issue (7): 854-.

• 论著（临床研究） • 上一篇    下一篇

氢质子磁共振波谱对胶质瘤周围区判断的应用价值

樊翊凌1, 王 勇1, 万杰清1, 周正文1, 江基尧1, 沈加林2, 李费平2   

  1. 上海交通大学 医学院仁济医院 1. 神经外科  2. 放射科, 上海 200127
  • 出版日期:2009-07-25 发布日期:2009-09-16
  • 通讯作者: 王 勇, 电子信箱：yongwang60@126.com。
  • 作者简介:樊翊凌（1975—）, 男, 主治医师, 硕士生；电子信箱: joulin-fan@hotmail.com。

Application of hydrogen proton magnetic resonance spectroscopy in diagnosis of peripheral tumor cell infiltration of gliomas

FAN Yi-ling1, WANG Yong1, WAN Jie-qing1, ZHOU Zheng-wen1, JIANG Ji-yao1, SHENG Jia-lin2, LI Fei-ping2   

  1. 1. Department of Neursurgery, 2. Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
  • Online:2009-07-25 Published:2009-09-16

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摘要：

目的 探讨氢质子磁共振波谱（1H-MRS）对胶质瘤肿瘤周围区判断的应用价值，及其与周围区肿瘤细胞浸润的相关性。方法 40例胶质瘤患者均在术前行1H-MRS检查，并按术后肿瘤病理分级分为低级别胶质瘤组（n=20）和高级别胶质瘤组（n=20）。在神经导航系统指导下实施肿瘤切除，同时获得事先标记的肿瘤周围区组织，并进行病理学检查。按病理切片是否含有肿瘤细胞分为阳性组和阴性组，分析两组不同周围区（1、2、3区）病理学表现和1H-MRS值的差异。结果 低级别胶质瘤组除1例患者在周围1区有肿瘤浸润，其余各区均未发现肿瘤浸润现象；高级别胶质瘤组在各周围区均发现肿瘤浸润现象。高级别胶质瘤的阳性组（n=24）和阴性组（n=36）各区的1H-MRS值比较，差异均无统计学意义（P>0.05）。结论 1H-MRS对于肿瘤周围区的诊断具有较好的应用价值，结合神经导航系统可实现肿瘤真正意义上的全切除，但相关技术尚待进一步改进。

关键词: 氢质子磁共振波谱, 神经导航系统\胶质瘤

Abstract:

Objective To explore the application of hydrogen proton magnetic resonance spectroscopy（1H-MRS）in the diagnosis of peripheral tumor cell infiltration of gliomas. Methods Forty patients with glioma were examined by 1H-MRS preoperation, and were divided into low grade glioma group (n=20) and high grade glioma group (n=20) according to postoperative pathological diagnosis. Tumor resection with peripheral tissues marked previously was carried out under the guidance of neuronavigator system. All the pathological sections were divided into positive group and negative group according to the presence or absence of tumor cells, and the differences in pathological findings of peripheral regions (region 1, 2 and 3) and 1H-MRS values were analyzed in these two groups. Results No infiltration was found in the peripheral regions of low grade glioma group except for one case in peripheral region 1, while infiltration was found in all peripheral regions of high grade glioma group. There was no significant difference in 1H-MRS values between positive group (n=24) and negative group (n=36) in patients with high grade glioma (P>0.05）. Conclusion 1H-MRS enjoys some advantages over routine radiological examinations in the diagnosis of peripheral tumor cell infiltration of gliomas. Total removal can be expected when combined with neuronavigator system, while there is room for improvement for relevant techniques.

Key words: hydrogen proton magnetic resonance spectroscopy, neuronavigator, glioma