人脑及脑肿瘤～1H磁共振波谱研究
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摘要
在近15年里，磁共振技术的临床应用迅猛发展，已成为影像学(特别是神经放射学)重要的检查方法。磁共振成像(MRI)可用以人体解剖结构的观察。磁共振技术的另一个分支——磁共振波谱(MRS)技术提供了一种无损伤性检测人体生理和生化代谢的新方法。
脑肿瘤是临床常见病，年发生率为10／10万，每年死于肿瘤的患者2.5％是脑肿瘤。由于颅内肿瘤的解剖特点，不能象其他部位的肿瘤一样容易进行探查手术。因此术前及时而准确的定位和定性诊断尤为重要。~1H—NMR波谱技术提供了一种无创研究脑和脑疾患时生化代谢改变的新方法。国外已有学者应用该技术对脑肿瘤进行了部分研究，但结果存在着差异，国内在该领域仍是空白。
本研究的目的
1．应用~1H磁共振波谱研究正常人脑内某些化合物的含量及脑内分布情况。
2．观察影响波谱测量的技术因素。
3．观察脑肿瘤的~1H磁共振波谱改变，分析其生化特点及~1H波谱在脑肿瘤诊断中的意义。
4．探讨波谱改变与肿瘤DNA含量及肿瘤增殖活性的关系。
材料和研究方法
1．应用1.5特斯拉MRI仪对18例正常人脑进行~1H波谱测试。测量区包括灰质、白质、小脑和丘脑，所用序列为STEAM。
2．选择不同扫描参数对5例正常人及含乙酸和乳酸的标准水模进行测试。
In the last 15 years, NMR has become more popular clinical practice, and was accepted as a new and promising modality in ima-geology, especialy in neuroradiology. Besides the visualization of the internal anotomy of the body, this technique also afford a non-invasive facilitie looking into the physiological and biochemical changes of living human body, that is magnetic resonance spectroscopy (MRS).
Brain tumor are not rare, The annual incidence of brain tumor is about 10 per 100,000 population, and approximately 2.5% of all cancer deaths are caused by brain tumor. For it's location in particular, it is very important to make accurate diagnosis including an-otomic location and pathologic determination before hand instead of exploratory operation. Localizated proton MR spectroscopy has provided a non-invasive method to investigate either normal or pathologic brain metabolism. Some reports about the brain tumor are mainly
脑肿瘤是临床常见病，年发生率为10／10万，每年死于肿瘤的患者2.5％是脑肿瘤。由于颅内肿瘤的解剖特点，不能象其他部位的肿瘤一样容易进行探查手术。因此术前及时而准确的定位和定性诊断尤为重要。~1H—NMR波谱技术提供了一种无创研究脑和脑疾患时生化代谢改变的新方法。国外已有学者应用该技术对脑肿瘤进行了部分研究，但结果存在着差异，国内在该领域仍是空白。
本研究的目的
1．应用~1H磁共振波谱研究正常人脑内某些化合物的含量及脑内分布情况。
2．观察影响波谱测量的技术因素。
3．观察脑肿瘤的~1H磁共振波谱改变，分析其生化特点及~1H波谱在脑肿瘤诊断中的意义。
4．探讨波谱改变与肿瘤DNA含量及肿瘤增殖活性的关系。
材料和研究方法
1．应用1.5特斯拉MRI仪对18例正常人脑进行~1H波谱测试。测量区包括灰质、白质、小脑和丘脑，所用序列为STEAM。
2．选择不同扫描参数对5例正常人及含乙酸和乳酸的标准水模进行测试。
In the last 15 years, NMR has become more popular clinical practice, and was accepted as a new and promising modality in ima-geology, especialy in neuroradiology. Besides the visualization of the internal anotomy of the body, this technique also afford a non-invasive facilitie looking into the physiological and biochemical changes of living human body, that is magnetic resonance spectroscopy (MRS).
Brain tumor are not rare, The annual incidence of brain tumor is about 10 per 100,000 population, and approximately 2.5% of all cancer deaths are caused by brain tumor. For it's location in particular, it is very important to make accurate diagnosis including an-otomic location and pathologic determination before hand instead of exploratory operation. Localizated proton MR spectroscopy has provided a non-invasive method to investigate either normal or pathologic brain metabolism. Some reports about the brain tumor are mainly
引文
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9. Bottomley PA. MR spectroscopy of the Human heart: The status and the challenges. Radiology 1994; 691: 593
10. Kerviler ED, et al. Exercise-induced muscle modification: Study of healthy subjects and patients with metabolic myopathies with MR imaging and P-31 spectroscopy. Radiology 1991; 181: 259
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12. Roy SH. Combined use of surface electromyography and ~(31)P-NMR spectroscopy for the study of muscle disorders. Physical Therapy 1993; 73: 892.
13. Negendank WG. et al. Bone and soft-tissue lesions: Diagnosis with combined H-1 MR imaging and P-31 MR spectroscopy. Radiology 1989; 173: 181
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2. Pettegrew JW. NMR: Principles and Application to Biomedical Research. NewYork: springer—verleg press. 1990; V.
3. Moon RB, Richards JH. Determination of intracellular pH ~(31)p magnetic resonance. J. Biol. Chem. 1973; 248: 7276
4. Hoult DI, et al. Observation of tissue metabolites using ~(31)P nuclear magnetic resonance. Nature 1974; 252: 285
5. Keshavan MS, et al. Magnetic resonance spectroscopy in psychiatry: potential, pitfalls, and promise. Am. J. Psychiatry 1991; 148: 976
6. Henriksen O. MR spectroscopy in clinical research. Acta Radiologica 1994; 35: 96
7. Francis IR, et al. Malignant Hepatic Tumor: P—31 MR spectroscopy with one-dimensional chemical shift imaging. Radiology 1991; 180: 341.
8. Meyerhoff JD, et al. Alcoholic liver disease: Quantitative image-guided P-31 MR spectrocopy. Radiology 1989; 173: 393
9. Bottomley PA. MR spectroscopy of the Human heart: The status and the challenges. Radiology 1994; 691: 593
10. Kerviler ED, et al. Exercise-induced muscle modification: Study of healthy subjects and patients with metabolic myopathies with MR imaging and P-31 spectroscopy. Radiology 1991; 181: 259
11. Schiebler ML, et al. In vitro high resolution ~1H-spectroscopy of human prostate benign prostatic hyperplasia, normal peripheral zone and adenocarcinoma. Mag. Reson. Med. 1993; 29: 285
12. Roy SH. Combined use of surface electromyography and ~(31)P-NMR spectroscopy for the study of muscle disorders. Physical Therapy 1993; 73: 892.
13. Negendank WG. et al. Bone and soft-tissue lesions: Diagnosis with combined H-1 MR imaging and P-31 MR spectroscopy. Radiology 1989; 173: 181
14．于世林主编．波谱分析法．重庆，重庆大学出版社．1991；90
15．Voelter W，Breitmaier原著，穆启远等译．~(13)C核磁共振谱．兰州，兰州大学出版社．1988；3
16．陈星荣等著．全身CT和MRI．上海，上海医学大学出版社．1994；32
17．高元桂等著．核磁共振成像诊断学．北京，人民军医出版社．1993；P12
18. Brown CE, et al. Nuclear magnetic resonance (NMR) in clinical pathology: Current trends. Clin. Chem. 1984; 30: 606.
19. Brown JJ, et al. MR spectroscopy of heart. AJR 1990; 155: 1
20. Richard A, et al. Nuclear magnetic resonance in pathology, Ⅰ: principles and general aspects. Human Pathology 1991; 20: 1077
21. Heerschap A. Current status of human in vivo NMR spec- troscopy. European J. Radiology 1992; 14 :117
22. Negendank WG, et al. Proceedings of a national cancer institute workshop: MR spectroscopy and tumor cell biology. Radiology 1992; 185 (3) : 875
23. Pan JW et al. Volume localization with a single surface coil. J. Magn. Reson. 1989; 81 : 608
24. Granot J, et al. Volume-localizdd ~(31)P spectroscopy via combined selective presaturation and selective excitation. J. Magn. Re-son. 1990; 89 : 139.
25. Merboldt K. D, et al. Localized ~(31)P NMR spectroscopy of the adult human in vivo using stimulated-echo (STEAM) sequences. J. Magn. Reson. 1990; 89 : 343.
26. Sauter R, et al. Current status of clinically relevant techniques in magnetic resonance spectroscopy. Electro. Med. 1992; 60:37
27. Pappas AA, et al. Nuclear magnetic resonance spectroscopy in pathology: Ⅱ current and future clinical applications. Human Pathology 1992; 23 : 4
28. Rrichard JW. Magnetic resonance spectroscopy of the brain. Clinica Chimica Acta 1992; 206 : 115
29. Levine SR, et al. Human focal cerebral ischemia: evaluation of brain pH and energy metabolism with ~(31)P NMR spectroscopy. Radidogy 1992; 185 : 537
30. Ott D, et al. Human brain tumors: Assesement with in vivo proton MR spectroscopy. Radiology 1993; 186 : 745
31. Petroff OAC, et al. Cerebral intracellular pH by P-31 nuclear magnetic resonance spectroscopy. Neurology 1985; 35: 781
32. Seelig J, Burlina AP. Carbon—13 magnetic resonance in biology and medicine. Clinica Chemica Acta 1992; 206: 125
33. Malloy CR, et al. Contribution of exogenoas substrates to acetyl coenzyme A: Measurement by ~(13)C NMR under nosteady-state condition. Biochemistry 1990; 29: 6756
34. Monti JP. et al. High-resolution NMR studies of transmembrane cation transport in uremic patients. Biochem. Biophy. Acta 1990; 1027: 31.
35．桥本隆裕．他．脑~(23)Na MRI-正常人CT研究 1991；13：479
36. Wolf W, et al. Tumor trapping of 5-flurouracil in vivo ~(19)F NMR spectroscopic phamacokinetics in tumor-bearing humans and rabbits. Proc. Natl. Acad. Sci. USA. 1990; 87: 492
37. Shaefer S. Clinical nuclear magnetic resonance spectrosopy: insight into metabolism. Am J. Cardio. 1990; 16: 45F
38. Bottomley PA. Human in vivo NMR spectroscopy in diagnostic medicine: Clinical tool or research probe? Radiology 1989; 170: 1
39．国际抗癌联盟主编．《临床肿瘤手册》编译组译．临床肿瘤学手册．北京，科学出版社，1984；260
40. Laptook AR, et al. Use of ~(31)P magnetic resonance spectroscopy to characterize evolving brain damage after perinatal asphyxia. Neurology 1989; 29: 709
41. Vander KMS, et al. Age-dependent changes in localized proton and phosphorus MR spectroscopy of the brain. Radiology 1990; 176 : 509
42. Kreis R, et al. Development of the human brain in vivo quantification of metabolite and water content with proton magnetic resonance spectroscopy. MRM 1993; 30 :424
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