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脑部环形强化灶的MRI及MRS分析

龙源期刊网 http://www.wendangku.net/doc/96aacd5fcf2f0066f5335a8102d276a201296061.html

脑部环形强化灶的MRI及MRS分析

作者:李艳丽陈国云黄绍花马婷赵惠菊

来源:《中国医药科学》2012年第05期

[摘要] 目的观察脑部不同环形强化灶的MRI及MRS不同表现形式为诊断提供重要信息。方法回顾性分析58例患者的MRI表现及其中10例MRS的表现。结果脑部表现为环形强化的病变有:良恶性肿瘤、转移瘤、感染性病变(脑脓肿、结核瘤、寄生虫、获得性免疫缺陷综合征)、肿瘤术后,放射性脑损伤(晚期)、脱髓鞘病变及血管性病变等,可通过它们的发生部位、年龄、MRI征象及H-MRS分析测定:胶质瘤NAA下降明显、Cho明显升高、Cr轻度下降、Cho/Cr、Cho/NAA比值明显增高;转移瘤无NAA峰,可出现Lip峰;细菌性脑脓肿Lac峰明显,无NAA峰;脑囊虫Lac、醋酸盐峰和丙氨酸峰升高;弓形体病Lac峰和Lip峰明显升高;淋巴瘤Cho升高较明显,同时有更高的Lip峰,Cr明显降低,Cho/Cr的比值比所有级别胶质瘤都高。结论 MRI增强扫描与H-MRS检查配合起来,既能正确鉴别脑部多种环形

强化的病变,又能为临床选择导航、立体定向活检、γ刀等治疗方案提供重要依据。

[关键词] 脑内环形强化灶;磁共振成像;磁共振波谱;造影剂

[中图分类号] R445.2 [文献标识码] B [文章编号] 2095-0616(2012)05-110-03

MRI and MRS analysis of brain ring strengthen cooker

LI Yanli CHEN Guoyun HUANG Shaohua MA Ting ZHAO Huiju

Room MRI,the First People's Hospital of Qujing, Qujing 655000,China

[Abstract] Objective To observe MRI and MRS different performances of brain ring strengthen cooker to apply important information for the diagnosis. Methods We retrospective analysed of 58 examples's MRI changes and 10 examples's MRS changes. Results The brain behaved in the ring strengthen cooker pathological changed, including:benign and m alignancy tumor,metastatic tumor,infections(encephalopyosis,tuberculoma,parasite,acquired immunity deficiency syndrome AIDS),tumour post operation,radioactivity cerebral injury(later period),demyelization pathological changes,it came out by analyzing of their happened position,age,MRI symptom and H-MRS

that:glioma NAA drops obviously,Cho rises obviously,Cr drops lightly,Cho/Cr,Cho/NAA ratios increase obviously;metastatic tumor does not have NAA peak,Lip peak appears;bacterial encephalopyosis Lac Summit is obvious,does not have NAA peak;cerebral cysticercoids Lac,acetic acid salt peak and alanine peak rise;toxoplasmosis Lac peak and Lip peak rise obviously.lymphoma Cho rise obviously,meanwhile has higher Lip peak,Cr declines obviously,the ratio of Cho/Cr are higher than all the same level glioma. Conclusion The combination of MRI reinforcement scanning and H-MRS inspection can not only identify Brain diverse ring strengthen cooker pathological