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磁共振波谱在诊断颅内肿瘤中的应用.pptx

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会计学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(júbù)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(zhèngcháng)的1H-MRS表现DepartmentofNeurosurgery PekingUniversityPeople’sHospital 胶质瘤的1H-MRS表现(biǎoxiàn) 随胶质瘤级别增加，NAA逐渐(zhújiàn)下降，Cho逐渐(zhújiàn)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(jíbié)胶质瘤的1H-MRS表现高级别胶质瘤的1H-MRS表现(biǎoxiàn)第一组：Ⅰ级星形细胞(xìbāo)瘤第一组：Ⅱ-Ⅲ级星形细胞(xìbāo)瘤第一组：胶质母细胞瘤第二组：II级星形细胞(xìbāo)瘤第二组：III级间变少突胶质细胞(xìbāo)瘤第二组：胶质母细胞瘤胶质瘤不同(bùtónɡ)部位的MRS比较胶质瘤不同(bùtónɡ)部位的MRS比较肿瘤波谱(bōpǔ)显示NAA依次下降，Cho逐渐升高肿瘤波谱显示NAA、Cr依次(yīcì)明显下降，Cho依次(yīcì)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(shízhì)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(zhǒngliú)周围无水肿区有肿瘤(zhǒngliú)细胞浸润评价(píngjià)脑胶质瘤的预后胶质瘤放疗(fànɡliáo)3个月后Ⅱ级星形细胞(xìbāo)瘤术后及放疗后1年Ⅱ级星形细胞(xìbāo)瘤术后2年复发DepartmentofNeurosurgery PekingUniversityPeople’sHospital 脑膜瘤的1H-MRS表现(biǎoxiàn)左额顶脑膜瘤左枕叶脑膜瘤右颞叶脑膜瘤右额顶部(dǐnɡbù)镰旁纤维细胞型脑膜瘤恶