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磁共振波谱在诊断颅内肿瘤中的应用ppt课件.ppt

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DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital 目前在大多数颅内肿瘤1H-MRS表现为以下多种代谢物的局部脑组织中的浓度变化 DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital DepartmentofNeurosurgery PekingUniversityPeople’sHospital 正常的1H-MRS表现DepartmentofNeurosurgery PekingUniversityPeople’sHospital 胶质瘤的1H-MRS表现 随胶质瘤级别增加，NAA逐渐下降，Cho逐渐升高 Cho/NAA和Cho/Cr比值反映肿瘤级别比较稳定， 在所有的胶质母细胞瘤中均升高 Lac峰可出现于各级别组脑胶质瘤中，其峰值无 显著差异低级别胶质瘤的1H-MRS表现高级别胶质瘤的1H-MRS表现第一组：Ⅰ级星形细胞瘤第一组：Ⅱ-Ⅲ级星形细胞瘤第一组：胶质母细胞瘤第二组：II级星形细胞瘤第二组：III级间变少突胶质细胞瘤第二组：胶质母细胞瘤胶质瘤不同部位的MRS比较胶质瘤不同部位的MRS比较肿瘤波谱显示NAA依次下降，Cho逐渐升高肿瘤波谱显示NAA、Cr依次明显下降，Cho依次明显升高。 瘤体区出现Lip/Lac峰右颞叶胶质母细胞瘤 (1)对侧正常脑组织区 (2)肿瘤实质中心区 (3)周边区波谱图显示能够判定常规MR表现正常的肿瘤周围无水肿区有肿瘤细胞浸润评价脑胶质瘤的预后胶质瘤放疗3个月后Ⅱ级星形细胞瘤术后及放疗后1年Ⅱ级星形细胞瘤术后2年复发DepartmentofNeurosurgery PekingUniversityPeople’sHospital 脑膜瘤的1H-MRS表现左额顶脑膜瘤左枕叶脑膜瘤右颞叶脑膜瘤右额顶部镰旁纤维细胞型脑膜瘤恶性脑膜瘤MRS表现脑膜瘤术后复发的MRS表现DepartmentofNeurosurgery PekingUniversityPeople’sHospital 转移瘤的1H-MRS表现转移瘤不同部位的MRS比较右额叶脑转移瘤左顶叶脑转移瘤左枕叶转移瘤转移瘤MRS的乳酸Lac和脂质Lip峰Depa