Differentiation among Metastatic Brain Tumors, Radiation Necroses, and Brain Abscesses Using Proton Magnetic Resonance Spectroscopy

利用核磁共振光譜分辨轉移性腦瘤、放射後壞死及腦膿瘍

黃燕芬(Yan-Fen Hwang) ； 黃祖源(Tzuu-Yuan Huang) ； 黃旭霖(Shiuh-Lin Hwang) ； 關暟麗(Aij-Lie Kwan) ； 洪純隆(Shen-Long Howng)

《The Kaohsiung Journal of Medical Sciences》 20卷9期 (2004/09) Pp. 437-442

摘要

質子核磁共振光譜試以區分轉移性腦瘤、放射後壞死及腦膿瘍。十二個有病理證實的病灶，術前分析核磁共振掃描和質子核磁共振光譜。觀察病灶及周圍的四種主要代謝物的訊號強度：乙醯天門冬酸（NAA）、膽鹼化合物（Cho）、磷酸肌酸（Cr）、及乳酸 (Lac）。轉移性腦瘤呈現 NAA/Cr下降與Cho/Cr上升，放射後壞死呈現 NAA/Cr下降與 Cho/C不變，腦膿瘍呈現Lac/Cr 上升。高Cho意指腫瘤生長轉化的結果，Lac則為微生物無氧代謝的結果。初步結論是核磁共振光譜有助於區分轉移性腦瘤、放射後壞死及腦膿瘍。

關鍵字

核磁共振掃描 ； 質子核磁共振光譜 ； 轉移性腦瘤 ； 放射後壞死 ； 腦膿瘍

並列摘要

Magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy (MRS) were evaluated for differentiating metastatic brain tumors, radiation necroses, and brain abscesses. Twelve histologically verified lesions in 12 patients were studied using preoperative MRI and proton MRS. The signal intensities of four major metabolites, N-acetyl aspartate (NAA), choline-containing compounds (Cho), creatine and phosphocreatine (Cr), and lactate (Lac), were observed over the region of interest. Metastatic brain tumors showed a decrease in NAA/Cr and an increase in Cho/Cr ratios. Radiation necroses showed a decrease in NAA/Cr and no change in Cho/Cr ratios. Brain abscesses showed an increase in Lac/Cr ratio. Correlation with histopathologic findings showed that a high Cho signal was suggestive of a metastatic brain tumor. Lac signals were observed in brain abscesses, presumably reflecting the anerobic glycolysis of living cells. Although more cases and studies are necessary, metabolic information provided by proton MRS combined with MRI is useful for differentiating among metastatic brain tumors, radiation necroses, and brain abscesses.

並列關鍵字

magnetic resonance imaging ； magnetic resonance spectroscopy ； metastatic brain radiation necrosis ； brain abscess