PWI联合MRS在鞍旁海绵状血管瘤与脑膜瘤鉴别诊断中的价值
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摘要
目的探讨灌注加权成像(perfusion weighted imaging,PWI)、磁共振波谱成像(magnetic resonance spectroscopy,MRS)对鞍旁海绵状血管瘤和鞍旁脑膜瘤的鉴别诊断价值。方法回顾性分析经证实的6例鞍旁海绵状血管瘤和10例鞍旁脑膜瘤患者磁共振常规扫描、MRS、PWI及增强扫描影像资料,测量肿瘤内最大局部血容量(region cerebral blood volume,rCBV)值与正常白质区局部血容量值并求两者的比值(nCBV),对两组间nCBV值进行统计学分析。结果常规和增强扫描在二者鉴别上困难,但鞍旁脑膜瘤组nCBV(6.119±2.564)值明显高于鞍旁海绵状血管瘤组nCBV(1.367±1.132),差异有显著性;鞍旁海绵状血管瘤波谱特点为无N-乙酰天门冬氨酸、胆碱和肌酸等峰,只见明显脂质峰;鞍旁脑膜瘤无N-乙酰天门冬氨酸、肌酸等峰,均见明显胆碱峰,3例可见丙氨酸峰,两者MRS表现具有明显差异性。结论 PWI联合MRS在鞍旁海绵状血管瘤与鞍旁脑膜瘤的鉴别诊断中具有较高的价值。
Objective To evaluate the perfusion weighted imaging(PWI) and magnetic resonance spectroscopy(MRS) cavernous hemangioma around the saddle and saddle beside the differential diagnosis of meningioma. Methods A retrospective analysis of six confirmed cases in the cavernous hemangioma and 10 cases in the patients with meningiomas mri routine scan, MRS, PWI and enhanced scan image data, measurement of tumour biggest region blood volume(rCBV) value and normal white matter area of region blood volume and ratio of the two(nCBV), statistical analysis was carried out on the nCBV values between the two groups. Results The results of conventional and enhanced scan in both difficult to identify, but the nCBV value of the meningioma near the saddle(6.119±2.564) was significantly higher than those in the cavernous hemangioma group(1.367±1.132).In the cavernous hemangioma spectrum characteristics to N-acetyl aspartate, choline and creatine peak, see clear lipid peak. Next to the saddle meningioma no N-acetyl aspartate, creatine, such as peak, 3 cases of visible peak alanine, see clear choline peak, both MRS has obvious differences in performance. Conclusion MRS joint PWI beside the saddle in the cavernous hemangioma and has high value in the differential diagnosis of meningioma.
Objective To evaluate the perfusion weighted imaging(PWI) and magnetic resonance spectroscopy(MRS) cavernous hemangioma around the saddle and saddle beside the differential diagnosis of meningioma. Methods A retrospective analysis of six confirmed cases in the cavernous hemangioma and 10 cases in the patients with meningiomas mri routine scan, MRS, PWI and enhanced scan image data, measurement of tumour biggest region blood volume(rCBV) value and normal white matter area of region blood volume and ratio of the two(nCBV), statistical analysis was carried out on the nCBV values between the two groups. Results The results of conventional and enhanced scan in both difficult to identify, but the nCBV value of the meningioma near the saddle(6.119±2.564) was significantly higher than those in the cavernous hemangioma group(1.367±1.132).In the cavernous hemangioma spectrum characteristics to N-acetyl aspartate, choline and creatine peak, see clear lipid peak. Next to the saddle meningioma no N-acetyl aspartate, creatine, such as peak, 3 cases of visible peak alanine, see clear choline peak, both MRS has obvious differences in performance. Conclusion MRS joint PWI beside the saddle in the cavernous hemangioma and has high value in the differential diagnosis of meningioma.
引文
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[13]肖华锋,马林等.三维动脉自旋标记灌注成像在鞍旁脑膜瘤与海绵状血管瘤中的鉴别诊断价值[J].中国医刊2014,49(4):68-70.
[14]孟淑萍,刘娜嘉,陈兵等.磁共振灌注成像在脑膜瘤诊断中的应用研究[J].宁夏医学院报,2008,30(5):578-580.
[15]李伟,龙晚生,罗学毛等.磁共振成像联合质子磁共振波谱在脑膜瘤中的应用研究[J].国际肿瘤学杂志,2010,37(11):877-880.
[16]Chuang CC,Jung SM,Yang JT,et al.Intrasellar cavernous hemangioma[J].J Clin Neurosci,2006,13(6):672-675.
[17]Elster AD,Challa VR,Gilbert TH,et al.Meningiomas:MR and histopathologic features[J].Radiology,1989,170(3):857-862.
[2]Linskey ME,Sekhar LN.Cavernous sinus hemangiomas:a series,a review,and an hypothesis[J].Neurosurgery,1992,30(1):101.
[3]Rossi A,Gandolfo C,Morana G,et al.New MR sequences(diffusion,perfusion,spectroscopy)in brain tumours[J].Pediatr Radiol,2010,40(6):999-1009.
[4]康巍,苏丹柯,刘丽东.磁共振成像新技术在鼻咽癌中的研究进展[J].中国CT和MRI杂志,2013,11(1):117-120.
[5]牛磊,朱蒙蒙,王明皓等,1H-MRS在颅内常见肿瘤中的临床应用[J].中国CT和MRI杂志,2014,12(3):32-36.
[6]杨纪周,王继伟,李挺,等.颅内海绵状血管瘤的CT和MRI诊断[J].放射学践,2007,22(9):915-918.
[7]牛磊,朱蒙蒙,王明皓等,鞍旁海绵状血管瘤的MRI诊断[J].医学影像学志,2013,23(7):998-1000.
[8]梁奕,周杰,杜柏林.鞍旁海绵状血管瘤与脑膜瘤的MR鉴别诊断[J].医学影像学杂志,2015,25(6)1103-1105.
[9]肖华锋,安维民,王玉林等.多模态磁共振成像技术在鞍旁海绵状血管瘤诊断中的应用价值[J].中国临床医生2014,42(6):68-70.
[10]白玉贞,韩晓东,牛广明.鞍旁海绵状血管瘤的MRI表现[J].临床放射学杂志,2010,29(12):1604-1607.
[11]牛磊,朱蒙蒙,王明皓,等.鞍旁海绵状血管瘤的MRI诊断[J].医学影像学杂志,2013,23(7):998-1000.
[12]徐焱,常慧贤,李彩霞,鞍旁海绵状血管瘤的MRI表现[J].医药与保健影像检验,2014,22(5):167.
[13]肖华锋,马林等.三维动脉自旋标记灌注成像在鞍旁脑膜瘤与海绵状血管瘤中的鉴别诊断价值[J].中国医刊2014,49(4):68-70.
[14]孟淑萍,刘娜嘉,陈兵等.磁共振灌注成像在脑膜瘤诊断中的应用研究[J].宁夏医学院报,2008,30(5):578-580.
[15]李伟,龙晚生,罗学毛等.磁共振成像联合质子磁共振波谱在脑膜瘤中的应用研究[J].国际肿瘤学杂志,2010,37(11):877-880.
[16]Chuang CC,Jung SM,Yang JT,et al.Intrasellar cavernous hemangioma[J].J Clin Neurosci,2006,13(6):672-675.
[17]Elster AD,Challa VR,Gilbert TH,et al.Meningiomas:MR and histopathologic features[J].Radiology,1989,170(3):857-862.