The Clinical Observation Of Brain Stereotactic Biopsy Under The Guidance Of The Proton Magnetic Resonance Spectroscopy

Objective: The objective of this thesis is to discuss the clinical value of stereotactic brain biopsy under the guidance of the proton magnetic resonance spectroscopy through comparing the brain stereotactic biopsy under the guidance of the proton magnetic resonance spectroscopy and the rate of brain stereotactic biopsy under the guidance of Magnetic Resonance Imaging(MRI).Methods: The author selects 30 cases randomly which are determined to be intracranial placeholder lesions by CT/MR, and imaging analysis is difficult to clear lesion property of difficult diseases. The author sets two groups of stereotactic biopsy targets on the same lesion site of the patient, one is the conventional MRI enhancement scanning guidance group(MRI group), the other is the proton magnetic resonance spectroscopy group(1H-MRS group). MRI group: the target site of the stereotactic brain lesion biopsy under the guidance of MRI is set in the obvious enhancement part, and central T2W1 high signal is regarded as the stereotactic biopsy targets; 1H-MRS group: the target site of the stereotactic brain lesion biopsy under the guidance of MRI+MRS is set in NAA and Cho, the larger areas of stereotactic brain lesion biopsy target. In order to reduce the patients’ pain and the risk of the surgery, the author tries to set the same puncture path in guarantee to avoid blood vessels, brain ditch and the important brain functional areas, which is three point one line puncture method. Through comparing the pathological positive results of the two groups, the author gets the accuracy of the two guidance groups.Result: There were no complications such as bleeding, infection, death and so on among the 30 cases in the two groups of guidance way under stereotactic puncture. Pathology results: 22 cases of brain glioma, 3 cases of lymphoma, 3 cases of demyelinating lesions, 1 case of inflammatory lesions, 1 case of cactuberculoma. The accuracy of the stereotactic biopsy diagnosis under the guidance of MRS is 100%(30/30). The accuracy of positive rate of the stereotactic biopsy diagnosis under the guidance of MRI is 96.7%(24/30).The accuracy rate is 80% of the enhanced stereotactic brain biopsy under the guidance of MRI group. The comparison difference has statistical significance(X2=4.17,P<0.05)Conclusion: The positive rate of the stereotactic biopsy group under the guidance of MRS is obviously higher than MRI. According to the metabolic characteristics of different tissue, 1H-MRS judges lesions internal composition and boundary, and guides the brain stereotactic biopsy targets and definition of scope to be an accurate, safe guidance way, which is worth further promotion and application in the clinical practice.