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題 名 | Proton Magnetic Resonance Spectroscopic Imaging of Cerebral Gliomas: Correlation of Metabolite Ratios with Histopathologic Grading=腦部膠質細胞瘤之質子磁振頻譜造影:代謝物比率與組織病理分級之相關性 |
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作 者 | 許元昱; 張承能; 魏國珍; 林坤榮; 徐文慶; 容世明; | 書刊名 | 長庚醫學 |
卷 期 | 27:6 2004.06[民93.06] |
頁 次 | 頁399-407 |
分類號 | 415.938 |
關鍵詞 | 腦部; 膠質細胞瘤; 質子磁振頻譜; Brain; Glioma; Proton MR spectroscopy; |
語 文 | 英文(English) |
中文摘要 | 背景:磁振頻譜造影可提供空間定位的代謝物資訊,改進腦部組織之特異性。本研究之主要目的,是評估磁振頻譜造影測量代謝物比率與腦部膠質細胞瘤組織病理分級之相關性。 方法:共有27位腦部膠質細胞瘤病患,於手術前接受磁振頻譜造影,包括10位II級,5位III級,12位IV級。振頻譜造影數據一般磁指影像在同一次檢查中獲得。分析的代謝物為N-乙醯天門冬胺酸鹽(NAA),肌胺酸-磷肌胺酸(Cr),含膽鹼化合物(Cho)和乳酸。 結果:與正常腦組織比較,膠質細胞瘤有顯著較低的NAA/Cr,以及較高的Cho/Cr,Cho/NAA和(Cho+Cr)/NAA(ps<0.001)。與世界衛生組織分級為II級的膠質細胞瘤比較,III級或IV級的膠質細胞瘤有顯著較低的NAA/Cr,以及較高的Cho/ NAA和(Cho+Cr)/NAA(ps≦0.05)。(Cho+Cr)/NAA與世界衛生組織分級有顯著相關(p<0.05)。III級與IV級的膠質細胞瘤之間並無顯著的代謝物差異(ps>0.1)。不同分級之間的乳酸出現率並無顯著差異(p=0.26)。 結論:質子磁振頻譜造影可提供膠質細胞瘤的代謝物資訊,而且(Cho+Cr)/NAA較其他代謝物比率更能區分不同惡性度的膠質細胞瘤。但是,不同級數之間的代謝物比率有相當大的重疊,無法以臨床磁振頻譜造影的結果判定單一膠質細胞瘤的世界衛生組織分級。 |
英文摘要 | Background: Magnetic resonance spectroscopic imaging (MRSI) can provide spatially encoded metabolite information and improve tissue specificity in human brains. The major goal of this study was to evaluate the correlation of metabolite ratios measured by MRSI with histopathological grading of cerebral gliomas. Methods: Twenty-seven patients with cerebral gliomas were referred consecutively for pre-surgical evaluation. The lesions included 10 grade II, 5 grade III, and 12 grade TV gliomas. MRSI data were acquired during the same session of conventional magnetic resonance imaging and analyzed in terms of N-acetylas-partate (NAA), creatine-phosphocreatine (Cr), choline-containing compounds (Cho), and lactate. Results: There were significantly lower NAA/Cr and higher Cho/Cr, Cho/NAA and (Cho+Cr)/NAA ratios (ps<0.001) in gliomas than in normal tissues. There were significantly lower NAA/Cr and higher Cho/NAA and (Cho+Cr)/NAA gliomas than in grade II gliomas. A significant correlation was identified between the (Cho+Cr)/NAA ratio and WHO grade (p<0.05). There was no significant metabolite difference between grade III and grade IV tumors (ps>0.1), or significant difference in lactate occurrence rates among different grades (p=0.26). Conclusions: Proton MRSI can provide in vivo information about the metabolic status of cerebral gliomas, and the (Cho+Cr)/NAA ratio can discriminate different grades better than other metabolite ratios. However, substantial overlap of metabolite ratios among different severities of malignancy makes it4 impossible to confirm the WHO grade of a specific cerebral glioma by using clinical MRSI. |
本系統中英文摘要資訊取自各篇刊載內容。