不同病理亚型脑膜瘤的1.5T磁共振质子波谱研究
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摘要
目的:
研究不同病理亚型脑膜瘤1.5T磁共振质子波谱表现,探讨各病理亚型脑膜瘤之间1.5T磁共振质子波谱的差别。
方法:
对42例影像学拟诊并经病理确诊为脑膜瘤的患者进行术前1.5T磁共振波谱检查,以病灶对侧或病灶周围相对正常脑实质谱线为对照,对病灶实质部分进行分析,将各病理亚型脑膜瘤谱线Glx、Ala、Lip“阳性率”及谱线尺测Cho/nCr比值进行统计学分析;同时对部分病灶周围水肿区进行波谱检查,对测得代谢物进行归纳。
结果:
①42例脑膜瘤谱线,除1例砂砾体型脑膜瘤谱线基线不稳之外的41例均表现为Cho峰明显升高、Cr及NAA峰明显降低、部分消失,均未见Lac峰,29例可见Ala峰,29例出现Lip峰;行35TE波谱检查的37例中30例可见增高、增宽的Glx峰;7例mI/Cr比值升高,包括2例脑膜皮细胞型脑膜瘤、1例纤维型脑膜瘤、3例过渡型脑膜瘤及1例非典型脑膜瘤。②尺测Cho/nCr比值在各病理亚型脑膜瘤之间及低高级脑膜瘤之间均无显著性差异(P值分别为0.768、0.461,LSD法多重比较得各病理亚型组间两两比较P值分别为0.788、0.468、0.334、0.788、0.691、0.505、0.468、0.691、0.734、0.334、0.505、0.734,均大于0.05)。③统计学分析提示Glx阳性率在不同亚型脑膜瘤组间可能有显著性差异(X2=10.833,P=0.013<0.05),进一步使用四格表Fisher精确概率检验提示差异表现在组别1与组别4之间(P=0.005<0.01),即Glx阳性率“脑膜皮细胞型脑膜瘤”组高于“本研究涉及的其它亚型脑膜瘤”组。④统计学分析提示Ala阳性率在不同亚型脑膜瘤组间可能有显著性差异(X2=9.107,P=0.028<0.05),进一步使用四格表Fisher精确概率检验提示差异表现在组别1与组别4及组别3与组别4之间(P值分别为0.019、0.032,均小于0.05),即Ala阳性率“脑膜皮细胞型脑膜瘤”组及“过渡型脑膜瘤”组均分别高于“本研究涉及的其它亚型脑膜瘤”组,但“脑膜皮细胞型脑膜瘤”组及“过渡型脑膜瘤”组本身之间Ala阳性率无显著性差异(P=1.000>0.05)。⑤Lip阳性率在不同亚型脑膜瘤组间没有显著性差异(X2=4.199,P=0.241>0.05)。⑥低高级脑膜瘤间Glx、Ala及Lip阳性率均无显著性差异(P值分别为0.223、0.576、0.302,均大于0.05)。⑦间变型脑膜瘤2例,肿瘤实质部分谱线均表现为单纯Lip峰明显升高、增宽合并明显升高的Cho峰。⑧脑膜瘤瘤周水肿区波谱分析6例中3例行35TE波谱检查,均可见增高或增宽的Glx峰,3例出现Ala峰,2例出现Lip峰,1例出现Lac峰,1例mI/Cr比值升高。
结论:
①脑膜瘤1.5T磁共振质子波谱表现为Cho明显升高、Cr及NAA峰明显降低、部分消失,多见Glx峰增高、增宽的改变及出现Ala峰,可见Lip峰,有时mI/Cr比值升高。②本组研究提示1.5T磁共振质子波谱分析时尺测Cho/nCr比值在各病理亚型脑膜瘤之间没有显著性差异。③本组研究提示1.5T磁共振质子波谱分析时Glx阳性率及Ala阳性率在部分亚型脑膜瘤组间可能有显著性差异。④本组研究提示1.5T磁共振质子波谱分析时Lip阳性率在不同亚型脑膜瘤组间没有显著性差异。
Purpose:
To study the proton MRS manifestation of meningiomas with different histopathologic subtypes on a 1.5T MR scanner and discuss the probable differences in it.
Methods:
1.5T MRS scans were given to 42 patients with meningiomas definitely diagnosed by imaging before their surgical operation. All cases were proved to be meningiomas by pathology after their operation. The MRS analyses were done in the parenchyma of the tumor,the relatively normal cerebral parenchyma of contralateral side or peritumoral area and peritumoral brain edema in part of the cases. The metabolites were analysed, such as Glx, Ala, Lac and Lip. The Cho/nCr ratio measured by a ruler was also reviewed. Statistic analyses were carried out.
Results:
①Except one case of psammomatous meningioma with a rough base line, all the 41 cases showed an obviously increased Cho peak and obvionsly decreased Cr and NAA, none of the 41 cases showed a Lac peak, Ala peak appeared in 29 cases, Lip appeared in 29 cases, 30 cases of the 37 cases with 35TE test showed increased Glx peaks. And among the 42 cases, mI/Cr ratio increased in 7 cases, including 2 cases of meningothelial meningioma, 1 case of fibrous meningioma, 3 cases of transitional meningioma and 1 case of atypical meningioma.②As for the Cho/nCr ratio measured by a ruler,there were no significant differences among all the histopathologic subtypes and between low grade and high grade meningiomas(all the P value higher than 0.05).③The stastistic analyses showed that there were probable significant differences among different histopathologic subtypes of meningiomas in the accurrence rate of Glx(P value lower than 0.05).The difference lay between group 1 and group4(P value lower than 0.05),giving the clue that the Glx occurrence rate of meningiothelial meningioma was higher than that of other subtypes meningioma.④The stastistic analyses showed that there were probable significant differences among different histopathologic subtypes of meningiomas in the accurrence rate of Ala(P value lower than 0.05).The differences lay between group 1 and group4,group 3 and group 4(both the P values lower than 0.05),giving the clues that the Ala occurrence rates of meningiothelial meningioma and transitional meningioma were both higher than that of other subtypes.⑤There were no significant differences among different histopathologic subtypes of meningiomas in the occurrence rate of Lip(all the P value higher than 0.05).⑥There were no significant differences in the occurrence rate of Glx,Ala and Lip between low grade and high grade meningioma(all the P values higher than 0.05).⑦An obviously increased Lip peak and an obviously increasd Cho peak appeared in 2 cases of anaplastic meningioma.⑧Among the 6 cases which analysed the peritumoral brain edema, 3 cases tested with 35TE showed increased Glx peaks, 3 cases showed Ala peaks, 2 cases showed Lip peaks, 1 case showed a Lac peak and the mI/Cr ratio increased in 1 case.
Conclusions:
①The 1.5T MRS of meningiomas displays obviously increased Cho, obviously discreased or even dispeared Cr and NAA and an increased Glx peak.It also displays that an Ala peak often appears, a Lip peak can be shown, sometimes an increased mI/Cr ratio can be measured.②Our 1.5T MRS study gives a clue that the Cho/nCr ratio(measured by a ruler) is no significantly different among different histopathologic subtypes of meningiomas.③Our stastistic analyses showed that there are probable significant differences among parts of the histopathologic subtypes of meningiomas in the accurrence rate of Glx and Ala.④Our 1.5T MRS study gives another clue that there are no significant differences among different histopathologic subtypes of meningiomas in the occurrence rate of Lip.
研究不同病理亚型脑膜瘤1.5T磁共振质子波谱表现,探讨各病理亚型脑膜瘤之间1.5T磁共振质子波谱的差别。
方法:
对42例影像学拟诊并经病理确诊为脑膜瘤的患者进行术前1.5T磁共振波谱检查,以病灶对侧或病灶周围相对正常脑实质谱线为对照,对病灶实质部分进行分析,将各病理亚型脑膜瘤谱线Glx、Ala、Lip“阳性率”及谱线尺测Cho/nCr比值进行统计学分析;同时对部分病灶周围水肿区进行波谱检查,对测得代谢物进行归纳。
结果:
①42例脑膜瘤谱线,除1例砂砾体型脑膜瘤谱线基线不稳之外的41例均表现为Cho峰明显升高、Cr及NAA峰明显降低、部分消失,均未见Lac峰,29例可见Ala峰,29例出现Lip峰;行35TE波谱检查的37例中30例可见增高、增宽的Glx峰;7例mI/Cr比值升高,包括2例脑膜皮细胞型脑膜瘤、1例纤维型脑膜瘤、3例过渡型脑膜瘤及1例非典型脑膜瘤。②尺测Cho/nCr比值在各病理亚型脑膜瘤之间及低高级脑膜瘤之间均无显著性差异(P值分别为0.768、0.461,LSD法多重比较得各病理亚型组间两两比较P值分别为0.788、0.468、0.334、0.788、0.691、0.505、0.468、0.691、0.734、0.334、0.505、0.734,均大于0.05)。③统计学分析提示Glx阳性率在不同亚型脑膜瘤组间可能有显著性差异(X2=10.833,P=0.013<0.05),进一步使用四格表Fisher精确概率检验提示差异表现在组别1与组别4之间(P=0.005<0.01),即Glx阳性率“脑膜皮细胞型脑膜瘤”组高于“本研究涉及的其它亚型脑膜瘤”组。④统计学分析提示Ala阳性率在不同亚型脑膜瘤组间可能有显著性差异(X2=9.107,P=0.028<0.05),进一步使用四格表Fisher精确概率检验提示差异表现在组别1与组别4及组别3与组别4之间(P值分别为0.019、0.032,均小于0.05),即Ala阳性率“脑膜皮细胞型脑膜瘤”组及“过渡型脑膜瘤”组均分别高于“本研究涉及的其它亚型脑膜瘤”组,但“脑膜皮细胞型脑膜瘤”组及“过渡型脑膜瘤”组本身之间Ala阳性率无显著性差异(P=1.000>0.05)。⑤Lip阳性率在不同亚型脑膜瘤组间没有显著性差异(X2=4.199,P=0.241>0.05)。⑥低高级脑膜瘤间Glx、Ala及Lip阳性率均无显著性差异(P值分别为0.223、0.576、0.302,均大于0.05)。⑦间变型脑膜瘤2例,肿瘤实质部分谱线均表现为单纯Lip峰明显升高、增宽合并明显升高的Cho峰。⑧脑膜瘤瘤周水肿区波谱分析6例中3例行35TE波谱检查,均可见增高或增宽的Glx峰,3例出现Ala峰,2例出现Lip峰,1例出现Lac峰,1例mI/Cr比值升高。
结论:
①脑膜瘤1.5T磁共振质子波谱表现为Cho明显升高、Cr及NAA峰明显降低、部分消失,多见Glx峰增高、增宽的改变及出现Ala峰,可见Lip峰,有时mI/Cr比值升高。②本组研究提示1.5T磁共振质子波谱分析时尺测Cho/nCr比值在各病理亚型脑膜瘤之间没有显著性差异。③本组研究提示1.5T磁共振质子波谱分析时Glx阳性率及Ala阳性率在部分亚型脑膜瘤组间可能有显著性差异。④本组研究提示1.5T磁共振质子波谱分析时Lip阳性率在不同亚型脑膜瘤组间没有显著性差异。
Purpose:
To study the proton MRS manifestation of meningiomas with different histopathologic subtypes on a 1.5T MR scanner and discuss the probable differences in it.
Methods:
1.5T MRS scans were given to 42 patients with meningiomas definitely diagnosed by imaging before their surgical operation. All cases were proved to be meningiomas by pathology after their operation. The MRS analyses were done in the parenchyma of the tumor,the relatively normal cerebral parenchyma of contralateral side or peritumoral area and peritumoral brain edema in part of the cases. The metabolites were analysed, such as Glx, Ala, Lac and Lip. The Cho/nCr ratio measured by a ruler was also reviewed. Statistic analyses were carried out.
Results:
①Except one case of psammomatous meningioma with a rough base line, all the 41 cases showed an obviously increased Cho peak and obvionsly decreased Cr and NAA, none of the 41 cases showed a Lac peak, Ala peak appeared in 29 cases, Lip appeared in 29 cases, 30 cases of the 37 cases with 35TE test showed increased Glx peaks. And among the 42 cases, mI/Cr ratio increased in 7 cases, including 2 cases of meningothelial meningioma, 1 case of fibrous meningioma, 3 cases of transitional meningioma and 1 case of atypical meningioma.②As for the Cho/nCr ratio measured by a ruler,there were no significant differences among all the histopathologic subtypes and between low grade and high grade meningiomas(all the P value higher than 0.05).③The stastistic analyses showed that there were probable significant differences among different histopathologic subtypes of meningiomas in the accurrence rate of Glx(P value lower than 0.05).The difference lay between group 1 and group4(P value lower than 0.05),giving the clue that the Glx occurrence rate of meningiothelial meningioma was higher than that of other subtypes meningioma.④The stastistic analyses showed that there were probable significant differences among different histopathologic subtypes of meningiomas in the accurrence rate of Ala(P value lower than 0.05).The differences lay between group 1 and group4,group 3 and group 4(both the P values lower than 0.05),giving the clues that the Ala occurrence rates of meningiothelial meningioma and transitional meningioma were both higher than that of other subtypes.⑤There were no significant differences among different histopathologic subtypes of meningiomas in the occurrence rate of Lip(all the P value higher than 0.05).⑥There were no significant differences in the occurrence rate of Glx,Ala and Lip between low grade and high grade meningioma(all the P values higher than 0.05).⑦An obviously increased Lip peak and an obviously increasd Cho peak appeared in 2 cases of anaplastic meningioma.⑧Among the 6 cases which analysed the peritumoral brain edema, 3 cases tested with 35TE showed increased Glx peaks, 3 cases showed Ala peaks, 2 cases showed Lip peaks, 1 case showed a Lac peak and the mI/Cr ratio increased in 1 case.
Conclusions:
①The 1.5T MRS of meningiomas displays obviously increased Cho, obviously discreased or even dispeared Cr and NAA and an increased Glx peak.It also displays that an Ala peak often appears, a Lip peak can be shown, sometimes an increased mI/Cr ratio can be measured.②Our 1.5T MRS study gives a clue that the Cho/nCr ratio(measured by a ruler) is no significantly different among different histopathologic subtypes of meningiomas.③Our stastistic analyses showed that there are probable significant differences among parts of the histopathologic subtypes of meningiomas in the accurrence rate of Glx and Ala.④Our 1.5T MRS study gives another clue that there are no significant differences among different histopathologic subtypes of meningiomas in the occurrence rate of Lip.
引文
1 杨正汉,冯逢,王霄英主编,祁吉,赵斌,陈敏主审. 磁共振成像技术指南――检查规范、临床策略及新技术应用
2 方虹,陈宪,郭庆林. 磁共振波谱(MRS)分析技术的原理. 国外医学临床放射学分册, 1995(4):201-205
3 Rudkin TM, Arnold DL. Proton Magnetic Resonance Spectroscopy for the Diagnosis and Management of Cerebral Disorders. Arch Neural, 1999 56(8):919-26
4 Paul Kleihues,Webster K.Cavenee 主编,李青,王哲,宋建华等编译. WHO肿瘤病理学及遗传学分类 神经系统肿瘤(2000)
5 Lara A.Brand?o,Romeu C.Dominues 著,刘筠主译,廉宗澂主审. 脑磁共振波谱成像
6 Keiko Imamura. Proton MR Spectroscopy of the Brain with a Focus on Chemical Issues. Magnetic Resonance in Medical Sciences, 2003 2(3):117-132
7 Nicola SD,Balestr P,Dotti MT. Severe metabolite abnormalities in the white matter of patients with vaculating megalencephalic leukoencephalopathy with subcortical cyst:a proton spectroscopic imaging study. J Neurol 2001 248:403-409
8 Mclean MA,Woermann FG,Barker GJ. Quantitative analysis of short echo time 1H-MRSI of cerebral gray and white matter. MRM 2000 44:401-411
9 Dawn E.Saunders. MD.Franklyn A Howe, Ph.D. et al. Aging of the adult human brain: in vivo quantitation of metabolite content with proton magnetic resonance spectroscopy. J Magn Reson Imaging, 1999 9(5):711-716
10 安维民,蔡幼铨,邱本胜,郭勇等. 健康成人脑代谢物浓度以及比值的 1HMRS研究. 中国医学影像学杂志, 2001 9(6):414-416
11 刘翼,李瑞春,吴珂等. 颅内常见肿瘤多体素质子磁共振波谱研究. 华西医学,2006 21(4):670-673
12 尉传社,刘志军,张俊祥等. 脑胶质瘤和脑膜瘤的二维多体素氢质子磁共振波谱. 中国医学影像技术,2003 19(11):1450-1452
13 Zhiyong Tong, Toshiaki Ymaki, Kuniaki Harada, Kiyohiro Houkin. In vivo quantifucation of the metabolites in normal brain and brain tumors by proton MR spectroscopy using water as an internal standard. Magnetic Resonance Imaing, 2004 22:1017-1024
14 王志群,李坤成,王亮等. 磁共振波谱成像对颅脑肿瘤的鉴别诊断价值. 放射学实践,2007 22(2):132-135
15 胡卫东,项立,范义等. 脑膜瘤磁共振氢质子波谱的初步研究. 中国医师进修杂志,2007 30(6):66-68
16 Kantarci K, Jack CR, Xu YC, Campeau NG, et al. Regional metabolic patterns in mild cognitive impairment and Alzheimer's disease: A 1H MRS study. Neurology, 2000 55(2):210-217
17 李向荣,龙莉玲. 肝性脑病的影像学研究. 放射学实践, 2005 20(12):1103-1105
18 龙淼淼,祁吉,尹建忠. 阿尔茨海默病和血管性痴呆氢质子磁共振波谱研究. 神经病学与康复学杂志, 2006 3(2):106-108, 117
19 齐志刚,沈天真,陈星荣. 氢质子磁共振波谱在脑膜瘤诊断中的应用. 中国医学计算机成像杂志, 2003 9(3):226-230
20 马隽,李吉,金银华等. 1H-MRS 鉴别脑膜瘤术后反应性损伤及残留与复发. 中国医学影像技术,2005 21(7):1009-1012
21 Majos C, Alonso J ,A guilera C, et al. Proton magnetic resonance spectroscopy (1H-MRS) of human brain tumors: assessment of differences between tumor types and its applicability in brain tumor categorization. Eur radio l, 2003, 13∶582-591
22 Krishnamoorthy T,Radhakrishnan VV,Thomas B,et al. Alanine peak in central neurocytomas on proton MR spectroscopy. Neuroradiology,2007 49(7):551-554
23 Hazany S , Hesselink JR , Healy JF , et al. Utilization of glutamate/creatine ratios for proton spectroscopic diagnosis ofmeningiomas. Neuroradiology,2007 49(2):121-127
24 于同刚,戴嘉中,冯晓源. 脑膜瘤的 MRI 及 1H-MRS 特点. 中国临床医学影像杂志, 2003 14(6):379-382
25 史瑞华,翟仁友,钱晓军等. 磁共振波谱成像在良恶性脑膜瘤鉴别诊断中的价值. 中国医学影像学技术,2006 22(5):674-677
26 彭洪娟,赵斌. 单体素1H-MRS在颅内肿瘤诊断与鉴别诊断中的应用价值研究. 山东大学 2005 届硕士学位论文
27 齐志刚,沈天真,陈星荣. 1H MRS 在常见脑肿瘤诊断中的初步应用. 中国医学计算机成像杂志,2004 10(1):8-14
28 齐志刚,沈天真. 3.0T 磁共振波谱在脑肿瘤诊断中的应用研究. 复旦大学华山医院 2005 届博士学位论文
29 Demir MK,Iplikcioglu AC,Dincer A,et al. Single voxel proton MR spectroscopy findings of typical and atypical intracranial meningiomas. Eur J Radiol. 2006 60(1):48-55
30 Manton DJ,Lowry M,Blackband SJ,et al. Determination of proton metabolite concentrations and relaxation parameters in normal human brain and intracranial tumors. NMR Biomed. 1995 8(3):104-112
1 Naishadh Shah, Ayesha Sattar, Michael Benanti, Scott Hollander, et al. Megnetic Resonance Spectroscopy as an Imaging Tool for Cancer: A Review of the Literature. JAOA, 2006 106(1):23-27
2 方虹,陈宪,郭庆林. 磁共振波谱(MRS)分析技术的原理. 国外医学临床放射学分册, 1995(4):201-205
3 Rudkin TM, Arnold DL. Proton Magnetic Resonance Spectroscopy for the Diagnosis and Management of Cerebral Disorders. Arch Neural, 1999 56(8):919-26
4 赵喜平. 磁共振成像系统的原理及其应用[M]. 北京:科学出版社, 2000 12
5 李爱军,白亮彩,张永权,张建生. 1H 磁共振波谱技术及其在脑肿瘤诊断中的应用. 国外医学神经病学神经外科学分册, 2005 32(3):207-210
6 彭洪娟, 赵 斌. 1 HMRS 基本原理及成像技术. 医学影像学杂志, 2004 14(12):1033-1035
7 Meyerand ME, Pipas JM, Mamourian A, et al . Classification of biopsy-confirmed brain tumors using single-voxel MR spectroscopy[J]. AJNR, 1999 20(1):117-123
8 Jeffry RA, Sophia CS, Albert B, et al. Absolute quantitation of short TE brain 1H-MR spectra and spectroscopic imaging data[J]. Journal of Computer Assisted Tomography, 1993 17(2):191-199
9 Lin CS, Fertikh D, Davis B, et al. 2D CSI proton MR spectroscopy of humanspinal vertebra : Feasibility studies[J]. J Magn Reson Imaging, 2000 11(3):287-293
10 Keiko Imamura. Proton MR Spectroscopy of the Brain with a Focus on Chemical Issues. Magnetic Resonance in Medical Sciences, 2003 2(3):117-132
11 Lara A.Brand?o,Romeu C.Dominues 著,刘筠主译,廉宗澂主审. 脑磁共振波谱成像. 2005 1:9-11
12 Dawn E.Saunders. MD.Franklyn A Howe, Ph.D. et al. Aging of the adult human brain: in vivo quantitation of metabolite content with proton magnetic resonance spectroscopy. J Magn Reson Imaging, 1999 9(5):711-716
13 安维民,蔡幼铨,邱本胜,郭勇等. 健康成人脑代谢物浓度以及比值的 1HMRS研究. 中国医学影像学杂志, 2001 9(6):414-416
14 Zhiyong Tong, Toshiaki Ymaki, Kuniaki Harada, Kiyohiro Houkin. In vivo quantifucation of the metabolites in normal brain and brain tumors by proton MR spectroscopy using water as an internal standard. Magnetic Resonance Imaing, 2004 22:1017-1024
15 Kantarci K, Jack CR, Xu YC, Campeau NG, et al. Regional metabolic patterns in mild cognitive impairment and Alzheimer's disease: A 1H MRS study. Neurology, 2000 55(2):210-217
16 李向荣,龙莉玲. 肝性脑病的影像学研究. 放射学实践, 2005 20(12):1103-1105
17 龙淼淼,祁吉,尹建忠. 阿尔茨海默病和血管性痴呆氢质子磁共振波谱研究. 神经病学与康复学杂志, 2006 3(2):106-108, 117
18 张冰,朱斌. ADC 图定位 1HMRS 在急性脑梗死分型分期中的临床研究. 临床放射学杂志, 2005 24(10):849-854
19 白旭,张云亭. 急性脑梗死的 1HMRS. 临床放射学杂志, 2005 24(1):7-11
20 雷军强,王晓慧,郭顺林. 1HMRS 技术及在颅脑疾病的应用. 中国医学理论与实践, 2006 16(8):996-997,1017
21 齐志刚,沈天真,陈星荣. 氢质子磁共振波谱在脑膜瘤诊断中的应用. 中国医学计算机成像杂志, 2003 9(3):226-230
22 彭洪娟,蔡世峰,赵斌. 1HMRS 在脑肿瘤中的应用. 医学影像学杂志, 2005 15 (2):161-163
23 田伟,杨桂芬. 1H-MRS 在脑星形细胞瘤术前分级中的价值. 放射学实践, 2005 20(9):753-756
24 彭娟, 罗天友. 1H-MRS 在脑肿瘤及肿瘤样病变的诊断与应用进展. 西部医学, 2005 9(17):517-519
25 鱼博浪,王斐,郭世萍,孙亲利. 1HMRS 在星形细胞肿瘤诊断中的应用. 实用放射学杂志, 2005 21(6):572-575
26 龚才桂,王小宜,刘 慧,周高峰. 1H-MRS 对低级别和高级别脑胶质瘤鉴别诊断的作用及病理级别相关性的研究. 临床放射学杂志, 2006 25(6):502-506
27 孙庚喜,罗柏宁,张 波. 1H-MRS 对脑转移瘤和恶性胶质瘤的鉴别诊断作用. 临床放射学杂志, 2005 24(11):955-959
28 Majos C, Alonso J ,A guilera C, et al. Proton magnetic resonance spectroscopy (1H-MRS) of human brain tumors: assessment of differences between tumor types and its applicability in brain tumor categorization. Eur radio l, 2003, 13∶582-591
29 龚才桂,王小宜,刘 慧,周高峰. 1H-MRS 在脑胶质瘤肿瘤周围组织的临床应用. 中国医学影像学技术, 2006 22(5):663-667
30 姜涛,张竞文,伍建林,宋清伟. 磁共振氢质子波谱对脑肿瘤瘤周水肿的临床应用研究. 中国医学计算机成像杂志, 2006 12(1):11-15
31 范国光,景奉东,吴振华,郭启勇. 1H 磁共振波谱在恶性胶质瘤与脑单发转移瘤鉴别诊断中的应用. 中国医学影像学杂志, 2004 12(1):4-6
32 于同刚,戴嘉中,冯晓源. 脑膜瘤的 MRI 及 1H-MRS 特点. 中国临床医学影像杂志, 2003 14(6):379-382
33 马隽,李吉,金银华等. 1H-MRS 鉴别脑膜瘤术后反应性损伤及残留与复发. 中国医学影像技术, 2005 21(7):1009-1012
34 何江波,姚振威,耿道颖. 肺癌脑转移瘤的常规 MR、DWI 及 MRS 诊断价值. 中国医学计算机成像杂志, 2005 11(4):227-231
35 刘红军,张云亭,刘松龄等. 高级别星形细胞瘤与脑单发转移瘤的 1H-MRS鉴别. 放射学实践, 2004 19(3):183-186
36 刘翼,李瑞,吴珂. 颅内常见肿瘤多体素质子磁共振波谱研究. 华西医学, 2006 21(4):670-673
37 赵斌,彭洪娟,杜沂山,蔡世峰. 中枢神经细胞瘤的 CT、MRI 及 1H-MRS 诊断. 实用放射学杂志, 2006 22(7):777-779
38 张勇,杨运俊,程敬亮. DWI 和 MRS 诊断缺血性脑梗死的病理生理学基础. 实用放射学杂志, 2005 21(3):318-320
39 Federico F, Simone IL, Lucivero V, et al. Prognostic value of proton magnetic resonance spectroscopy in ischemic stroke. Arch Neurol, 1998 55(4):489-494
40 Gillard JH, Barker PB, van Zijl PC, et al. Proton MR spectroscopy in acute middle cerebral artery stroke. AJNR Am J Neuroradiol, 1996 17(5):873-86
41 李月芬,彭海,王承缘等. 磁共振波谱分析对脑梗死的研究价值. 国外医学 物理医学与康复学分册, 2001 21(2):54-56
42 于同刚,戴嘉中,冯晓源. 原发性中枢神经系统淋巴瘤的 MRI 及 1HMRS 特点. 临床放射学杂志, 2005 24(8):668-672
43 杨桂芬,田伟. 2D1HMRS 的 Cho/NAA 参差 Z 积分在脑星形细胞瘤分级中的价值. 临床放射学杂志, 2005 24(4):297-300
44 郭红云,牛广明,韩晓东. 脑肿瘤的氢-磁共振波谱研究. 内蒙古医学院学报, 2000 22(1):24-28
45 周正荣,王玖华,刘宜春等. 颅脑肿瘤质子磁共振波谱研究. 中国临床神经科学, 2002 10(1):33-36,39
46 何慧瑾,沈天真,陈星荣,江澄川. 1H-MRS 在颞叶癫痫定侧诊断中的价值. 中国医学计算机成像杂志, 2000 6(6):361-366
47 齐静,杜湘珂,栾国明. 颞叶癫痫的 MRI 和 MRS 研究现状. 国外医学临床放射学分册, 2000 2:87-89
48 Petroff OA, Rothman DL,Behar KL, et al. Low brain GABA level is associated with poor seizure control. Ann Neurol, 1996 40(6):908-911
49 常华军,刘文,钱群等. 磁共振质子波谱分析对多发性硬化的诊断价值. 临床神经病学杂志, 2006 19(5):324-326
50 段云云,李坤成,于春水,秦文. 多发性硬化的磁共振波谱研究. 中国医学影像技术, 2006 22(1):67-69
51 武传华,周建峰,杨涛. 1H 磁共振波谱在脑多发性硬化诊断中的价值. 现代诊断与治疗, 2005 16(3):136-139
52 吴光耀,雷皓,孙骏谟等. 1H-MRS 在细菌性脑脓肿中的应用. 临床放射学杂志, 2006 25(3):213-217
53 王双坤,戴建平,程华. 对 15 例放射性脑损伤 MRI 及 MRS 征象的探讨. 中国临床医学影像学杂志, 2005 16(12):661-663
54 宋琼,夏黎明. 放射性脑损伤的磁共振波谱研究进展. 放射学实践, 2006 21(4):414-415
55 朱文珍,漆剑频,夏黎明等. 1H-MRS 技术及其在脑疾病的应用. 放射学实践, 2002 17(3):266-268
56 全伟,李铁林,陈光忠等. 1H-MRS 在蛛网膜下腔出血性脑血管痉挛发生时的评价作用. 南方医科大学学报, 2006 26(3):352-354
2 方虹,陈宪,郭庆林. 磁共振波谱(MRS)分析技术的原理. 国外医学临床放射学分册, 1995(4):201-205
3 Rudkin TM, Arnold DL. Proton Magnetic Resonance Spectroscopy for the Diagnosis and Management of Cerebral Disorders. Arch Neural, 1999 56(8):919-26
4 Paul Kleihues,Webster K.Cavenee 主编,李青,王哲,宋建华等编译. WHO肿瘤病理学及遗传学分类 神经系统肿瘤(2000)
5 Lara A.Brand?o,Romeu C.Dominues 著,刘筠主译,廉宗澂主审. 脑磁共振波谱成像
6 Keiko Imamura. Proton MR Spectroscopy of the Brain with a Focus on Chemical Issues. Magnetic Resonance in Medical Sciences, 2003 2(3):117-132
7 Nicola SD,Balestr P,Dotti MT. Severe metabolite abnormalities in the white matter of patients with vaculating megalencephalic leukoencephalopathy with subcortical cyst:a proton spectroscopic imaging study. J Neurol 2001 248:403-409
8 Mclean MA,Woermann FG,Barker GJ. Quantitative analysis of short echo time 1H-MRSI of cerebral gray and white matter. MRM 2000 44:401-411
9 Dawn E.Saunders. MD.Franklyn A Howe, Ph.D. et al. Aging of the adult human brain: in vivo quantitation of metabolite content with proton magnetic resonance spectroscopy. J Magn Reson Imaging, 1999 9(5):711-716
10 安维民,蔡幼铨,邱本胜,郭勇等. 健康成人脑代谢物浓度以及比值的 1HMRS研究. 中国医学影像学杂志, 2001 9(6):414-416
11 刘翼,李瑞春,吴珂等. 颅内常见肿瘤多体素质子磁共振波谱研究. 华西医学,2006 21(4):670-673
12 尉传社,刘志军,张俊祥等. 脑胶质瘤和脑膜瘤的二维多体素氢质子磁共振波谱. 中国医学影像技术,2003 19(11):1450-1452
13 Zhiyong Tong, Toshiaki Ymaki, Kuniaki Harada, Kiyohiro Houkin. In vivo quantifucation of the metabolites in normal brain and brain tumors by proton MR spectroscopy using water as an internal standard. Magnetic Resonance Imaing, 2004 22:1017-1024
14 王志群,李坤成,王亮等. 磁共振波谱成像对颅脑肿瘤的鉴别诊断价值. 放射学实践,2007 22(2):132-135
15 胡卫东,项立,范义等. 脑膜瘤磁共振氢质子波谱的初步研究. 中国医师进修杂志,2007 30(6):66-68
16 Kantarci K, Jack CR, Xu YC, Campeau NG, et al. Regional metabolic patterns in mild cognitive impairment and Alzheimer's disease: A 1H MRS study. Neurology, 2000 55(2):210-217
17 李向荣,龙莉玲. 肝性脑病的影像学研究. 放射学实践, 2005 20(12):1103-1105
18 龙淼淼,祁吉,尹建忠. 阿尔茨海默病和血管性痴呆氢质子磁共振波谱研究. 神经病学与康复学杂志, 2006 3(2):106-108, 117
19 齐志刚,沈天真,陈星荣. 氢质子磁共振波谱在脑膜瘤诊断中的应用. 中国医学计算机成像杂志, 2003 9(3):226-230
20 马隽,李吉,金银华等. 1H-MRS 鉴别脑膜瘤术后反应性损伤及残留与复发. 中国医学影像技术,2005 21(7):1009-1012
21 Majos C, Alonso J ,A guilera C, et al. Proton magnetic resonance spectroscopy (1H-MRS) of human brain tumors: assessment of differences between tumor types and its applicability in brain tumor categorization. Eur radio l, 2003, 13∶582-591
22 Krishnamoorthy T,Radhakrishnan VV,Thomas B,et al. Alanine peak in central neurocytomas on proton MR spectroscopy. Neuroradiology,2007 49(7):551-554
23 Hazany S , Hesselink JR , Healy JF , et al. Utilization of glutamate/creatine ratios for proton spectroscopic diagnosis ofmeningiomas. Neuroradiology,2007 49(2):121-127
24 于同刚,戴嘉中,冯晓源. 脑膜瘤的 MRI 及 1H-MRS 特点. 中国临床医学影像杂志, 2003 14(6):379-382
25 史瑞华,翟仁友,钱晓军等. 磁共振波谱成像在良恶性脑膜瘤鉴别诊断中的价值. 中国医学影像学技术,2006 22(5):674-677
26 彭洪娟,赵斌. 单体素1H-MRS在颅内肿瘤诊断与鉴别诊断中的应用价值研究. 山东大学 2005 届硕士学位论文
27 齐志刚,沈天真,陈星荣. 1H MRS 在常见脑肿瘤诊断中的初步应用. 中国医学计算机成像杂志,2004 10(1):8-14
28 齐志刚,沈天真. 3.0T 磁共振波谱在脑肿瘤诊断中的应用研究. 复旦大学华山医院 2005 届博士学位论文
29 Demir MK,Iplikcioglu AC,Dincer A,et al. Single voxel proton MR spectroscopy findings of typical and atypical intracranial meningiomas. Eur J Radiol. 2006 60(1):48-55
30 Manton DJ,Lowry M,Blackband SJ,et al. Determination of proton metabolite concentrations and relaxation parameters in normal human brain and intracranial tumors. NMR Biomed. 1995 8(3):104-112
1 Naishadh Shah, Ayesha Sattar, Michael Benanti, Scott Hollander, et al. Megnetic Resonance Spectroscopy as an Imaging Tool for Cancer: A Review of the Literature. JAOA, 2006 106(1):23-27
2 方虹,陈宪,郭庆林. 磁共振波谱(MRS)分析技术的原理. 国外医学临床放射学分册, 1995(4):201-205
3 Rudkin TM, Arnold DL. Proton Magnetic Resonance Spectroscopy for the Diagnosis and Management of Cerebral Disorders. Arch Neural, 1999 56(8):919-26
4 赵喜平. 磁共振成像系统的原理及其应用[M]. 北京:科学出版社, 2000 12
5 李爱军,白亮彩,张永权,张建生. 1H 磁共振波谱技术及其在脑肿瘤诊断中的应用. 国外医学神经病学神经外科学分册, 2005 32(3):207-210
6 彭洪娟, 赵 斌. 1 HMRS 基本原理及成像技术. 医学影像学杂志, 2004 14(12):1033-1035
7 Meyerand ME, Pipas JM, Mamourian A, et al . Classification of biopsy-confirmed brain tumors using single-voxel MR spectroscopy[J]. AJNR, 1999 20(1):117-123
8 Jeffry RA, Sophia CS, Albert B, et al. Absolute quantitation of short TE brain 1H-MR spectra and spectroscopic imaging data[J]. Journal of Computer Assisted Tomography, 1993 17(2):191-199
9 Lin CS, Fertikh D, Davis B, et al. 2D CSI proton MR spectroscopy of humanspinal vertebra : Feasibility studies[J]. J Magn Reson Imaging, 2000 11(3):287-293
10 Keiko Imamura. Proton MR Spectroscopy of the Brain with a Focus on Chemical Issues. Magnetic Resonance in Medical Sciences, 2003 2(3):117-132
11 Lara A.Brand?o,Romeu C.Dominues 著,刘筠主译,廉宗澂主审. 脑磁共振波谱成像. 2005 1:9-11
12 Dawn E.Saunders. MD.Franklyn A Howe, Ph.D. et al. Aging of the adult human brain: in vivo quantitation of metabolite content with proton magnetic resonance spectroscopy. J Magn Reson Imaging, 1999 9(5):711-716
13 安维民,蔡幼铨,邱本胜,郭勇等. 健康成人脑代谢物浓度以及比值的 1HMRS研究. 中国医学影像学杂志, 2001 9(6):414-416
14 Zhiyong Tong, Toshiaki Ymaki, Kuniaki Harada, Kiyohiro Houkin. In vivo quantifucation of the metabolites in normal brain and brain tumors by proton MR spectroscopy using water as an internal standard. Magnetic Resonance Imaing, 2004 22:1017-1024
15 Kantarci K, Jack CR, Xu YC, Campeau NG, et al. Regional metabolic patterns in mild cognitive impairment and Alzheimer's disease: A 1H MRS study. Neurology, 2000 55(2):210-217
16 李向荣,龙莉玲. 肝性脑病的影像学研究. 放射学实践, 2005 20(12):1103-1105
17 龙淼淼,祁吉,尹建忠. 阿尔茨海默病和血管性痴呆氢质子磁共振波谱研究. 神经病学与康复学杂志, 2006 3(2):106-108, 117
18 张冰,朱斌. ADC 图定位 1HMRS 在急性脑梗死分型分期中的临床研究. 临床放射学杂志, 2005 24(10):849-854
19 白旭,张云亭. 急性脑梗死的 1HMRS. 临床放射学杂志, 2005 24(1):7-11
20 雷军强,王晓慧,郭顺林. 1HMRS 技术及在颅脑疾病的应用. 中国医学理论与实践, 2006 16(8):996-997,1017
21 齐志刚,沈天真,陈星荣. 氢质子磁共振波谱在脑膜瘤诊断中的应用. 中国医学计算机成像杂志, 2003 9(3):226-230
22 彭洪娟,蔡世峰,赵斌. 1HMRS 在脑肿瘤中的应用. 医学影像学杂志, 2005 15 (2):161-163
23 田伟,杨桂芬. 1H-MRS 在脑星形细胞瘤术前分级中的价值. 放射学实践, 2005 20(9):753-756
24 彭娟, 罗天友. 1H-MRS 在脑肿瘤及肿瘤样病变的诊断与应用进展. 西部医学, 2005 9(17):517-519
25 鱼博浪,王斐,郭世萍,孙亲利. 1HMRS 在星形细胞肿瘤诊断中的应用. 实用放射学杂志, 2005 21(6):572-575
26 龚才桂,王小宜,刘 慧,周高峰. 1H-MRS 对低级别和高级别脑胶质瘤鉴别诊断的作用及病理级别相关性的研究. 临床放射学杂志, 2006 25(6):502-506
27 孙庚喜,罗柏宁,张 波. 1H-MRS 对脑转移瘤和恶性胶质瘤的鉴别诊断作用. 临床放射学杂志, 2005 24(11):955-959
28 Majos C, Alonso J ,A guilera C, et al. Proton magnetic resonance spectroscopy (1H-MRS) of human brain tumors: assessment of differences between tumor types and its applicability in brain tumor categorization. Eur radio l, 2003, 13∶582-591
29 龚才桂,王小宜,刘 慧,周高峰. 1H-MRS 在脑胶质瘤肿瘤周围组织的临床应用. 中国医学影像学技术, 2006 22(5):663-667
30 姜涛,张竞文,伍建林,宋清伟. 磁共振氢质子波谱对脑肿瘤瘤周水肿的临床应用研究. 中国医学计算机成像杂志, 2006 12(1):11-15
31 范国光,景奉东,吴振华,郭启勇. 1H 磁共振波谱在恶性胶质瘤与脑单发转移瘤鉴别诊断中的应用. 中国医学影像学杂志, 2004 12(1):4-6
32 于同刚,戴嘉中,冯晓源. 脑膜瘤的 MRI 及 1H-MRS 特点. 中国临床医学影像杂志, 2003 14(6):379-382
33 马隽,李吉,金银华等. 1H-MRS 鉴别脑膜瘤术后反应性损伤及残留与复发. 中国医学影像技术, 2005 21(7):1009-1012
34 何江波,姚振威,耿道颖. 肺癌脑转移瘤的常规 MR、DWI 及 MRS 诊断价值. 中国医学计算机成像杂志, 2005 11(4):227-231
35 刘红军,张云亭,刘松龄等. 高级别星形细胞瘤与脑单发转移瘤的 1H-MRS鉴别. 放射学实践, 2004 19(3):183-186
36 刘翼,李瑞,吴珂. 颅内常见肿瘤多体素质子磁共振波谱研究. 华西医学, 2006 21(4):670-673
37 赵斌,彭洪娟,杜沂山,蔡世峰. 中枢神经细胞瘤的 CT、MRI 及 1H-MRS 诊断. 实用放射学杂志, 2006 22(7):777-779
38 张勇,杨运俊,程敬亮. DWI 和 MRS 诊断缺血性脑梗死的病理生理学基础. 实用放射学杂志, 2005 21(3):318-320
39 Federico F, Simone IL, Lucivero V, et al. Prognostic value of proton magnetic resonance spectroscopy in ischemic stroke. Arch Neurol, 1998 55(4):489-494
40 Gillard JH, Barker PB, van Zijl PC, et al. Proton MR spectroscopy in acute middle cerebral artery stroke. AJNR Am J Neuroradiol, 1996 17(5):873-86
41 李月芬,彭海,王承缘等. 磁共振波谱分析对脑梗死的研究价值. 国外医学 物理医学与康复学分册, 2001 21(2):54-56
42 于同刚,戴嘉中,冯晓源. 原发性中枢神经系统淋巴瘤的 MRI 及 1HMRS 特点. 临床放射学杂志, 2005 24(8):668-672
43 杨桂芬,田伟. 2D1HMRS 的 Cho/NAA 参差 Z 积分在脑星形细胞瘤分级中的价值. 临床放射学杂志, 2005 24(4):297-300
44 郭红云,牛广明,韩晓东. 脑肿瘤的氢-磁共振波谱研究. 内蒙古医学院学报, 2000 22(1):24-28
45 周正荣,王玖华,刘宜春等. 颅脑肿瘤质子磁共振波谱研究. 中国临床神经科学, 2002 10(1):33-36,39
46 何慧瑾,沈天真,陈星荣,江澄川. 1H-MRS 在颞叶癫痫定侧诊断中的价值. 中国医学计算机成像杂志, 2000 6(6):361-366
47 齐静,杜湘珂,栾国明. 颞叶癫痫的 MRI 和 MRS 研究现状. 国外医学临床放射学分册, 2000 2:87-89
48 Petroff OA, Rothman DL,Behar KL, et al. Low brain GABA level is associated with poor seizure control. Ann Neurol, 1996 40(6):908-911
49 常华军,刘文,钱群等. 磁共振质子波谱分析对多发性硬化的诊断价值. 临床神经病学杂志, 2006 19(5):324-326
50 段云云,李坤成,于春水,秦文. 多发性硬化的磁共振波谱研究. 中国医学影像技术, 2006 22(1):67-69
51 武传华,周建峰,杨涛. 1H 磁共振波谱在脑多发性硬化诊断中的价值. 现代诊断与治疗, 2005 16(3):136-139
52 吴光耀,雷皓,孙骏谟等. 1H-MRS 在细菌性脑脓肿中的应用. 临床放射学杂志, 2006 25(3):213-217
53 王双坤,戴建平,程华. 对 15 例放射性脑损伤 MRI 及 MRS 征象的探讨. 中国临床医学影像学杂志, 2005 16(12):661-663
54 宋琼,夏黎明. 放射性脑损伤的磁共振波谱研究进展. 放射学实践, 2006 21(4):414-415
55 朱文珍,漆剑频,夏黎明等. 1H-MRS 技术及其在脑疾病的应用. 放射学实践, 2002 17(3):266-268
56 全伟,李铁林,陈光忠等. 1H-MRS 在蛛网膜下腔出血性脑血管痉挛发生时的评价作用. 南方医科大学学报, 2006 26(3):352-354