| Objective: The goal of this study is to investigate the use of multi-voxel proton magnetic resonance spectroscopy as a diagnostic and differential-diagnosis method of intracranial tumors.Methods:The multi-voxel ~1HMRS data of 40 intracranial-tumor patients confirmed by pathologic study was reviewed. Based on the pathologic results, the difference of values of main metabolites and their relative ratio was studied not only between the tumor and contralateral brain tissue located at the corresponding place to the tumor, but also among different types of the tumors. And the extent of the difference was quantitatively studied. Further more, we assessed the value of multi-voxel proton magnetic resonance spectroscopy as a diagnostic and differential-diagnosis indicator of intracranial tumors.Results: (1) The values of NAA, Cho and MI differ between gliomas and the contralateral brain tissues(p<0.05); the values of NAA, Cho, MI and Lac differ between meningiomas and contralateral brain tissues(p<0.05); the values of NAA, Cho and MI differ between acoustic neurilemomas and contralateral brain tissues(p<0.05).(2) The values of NAA/Cr, Cho/Cr, NAA/Cho and MI/Cr differbetween gliomas and contralateral brain tissues(p<0.05); the values of NAA/Cr, Cho/Cr, NAA/Cho and Lac/Cr differ between meningiomas and contralateral brain tissues(p<0.05); the values of NAA/Cho and Ml/Cr differbetween acoustic neurilemomas and contralateral brain tissues (p<0.05).(3) The values of ANAA and ACho differ between gliomas and meningiomas(p<0.05)—the 95% confidence interval of ANAA of gliomas is -6.38—2.56, while that of meningiomas is -11.58~-6.59; the 95% confidence interval of ACho of gliomas is 3.16-6.97, while that of meningiomas is 5.89-10.20.(4) The values of ACho/Cr, ANAA/Cr and ANAA/Cho differ between gliomas and meningiomas(p<0.05)—the 95% confidence interval of ANAA/Cr of gliomas is -1.22- -0.40, while that of meningiomas is -3.53- -1.68; the 95% confidence interval of ACho/Cr of gliomas is 0.61-1.50, while that of meningiomas is 1.68-4.32; the 95% confidence interval of ANAA/Cho of gliomas is -1.98- -0.96, while that of meningiomas is -4.06- -1.94.(5) Compared with the contralateral brain tissues, the value of NAA of the metastatic tumor decreased, and the values of Cho and Lac of it increased predominantly; the value of Cho of craniopharyngioma decreased, so did the value of NAA.Conclusion: (1) Multi-voxel'HMRS can get MRS signals from different areas at the same time, so that it can get more comprehensive information about the metabolism of intracranial tissues. It also help selecte the exact voxel without inclusion of unwanted structures that may degrade the spectrum quality. (2) Multi-voxel 'HMRS can clearly and sensitively demonstrate the difference of metabolic situation not only between intracranial tumors and the contralateral brain tissues, but also among the different kinds of intracranial tumors, in that, it is valuable in the field of diagnosis and differential diagnosis of intracranial tumors. (3) Both absolute values and relative ratio of the metabolites should be calculated during the multi-voxel 'HMRS studies. (4) Ametabolite is a set of new indicators we put forward in our study, which is useful in tumors diagnosis and need further study. |
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