The Clinical Application Of Multi-voxel Proton Magnetic Resonance Spectroscopy In Diagnosing Tumors Of Musculoskeletal Tumors

Objective Doing musculoskeletal tumors voxel proton spectroscopy scan by using theU.S. GE signa Excite HDX Ⅱ3.0T MRI scanner and company configurations1H-MRSscanning system. Analysis the lesions’ characteristics in MRI signal, studying benign andmalignant musculoskeletal tumors with2D multi-voxel1H-magneticresonance spectroscopyat Excite HDX3.0T magnetic resonance instrument, explore the1H-MRS imagingcharacteristics and assess the value of1H-MRS in diagnosing musculoskeletal tumors anddistinguishing benign from malignant tumors.Methods Totally33patients with clinically and pathologically confirmedmusculoskeletal tumors were enrolled in this study. MRI、MRI enhanced and2D multi-voxel1H-MRS scans was performed before surgery. The imaging characteristics of2D1H-MRSwere observed for musculoskeletal tumors. Then calculated the Cho/Cr and Lip/Cr bystatistical analysis.Results Benign and malignant musculoskeletal tumors conventional MRI scancharacteristics are significantly different，benign musculoskeletal tumors have the clear signaluniformity, no violations of the surrounding tissue, malignant tumors involving the largerscope, T2WI performance mixed signals, the surrounding structures were violationed and thesurrounding tissue have a small amount of soft tissue edema, the use of conventional MRIdiagnosis of benign and malignant musculoskeletal tumors with a sensitivity of77%and a specificity of70%and an accuracy of73%.1H-MRS spectra of musculoskeletal tumors weredifferent from those of the normal muscles, the1H-MRS examination appeared in both Cho(3.22ppm), Cr (3.02ppm) and Lip (1.2ppm and1.5ppm) peak of normal lower limb muscles.In this study，there are20cases of benign，18cases of benign lesions may appear low Cho、C r、Lip peaks，2cases of neurofibromas seen higher Cho peak, and have a higher NAA peak.The Cho peak was extremely higher than Cr peak among malignant tumors，11cases ofcancer occurs higher Cho peak, but two cases of osteosarcoma appears low Cho peak. TheLip/Cr values of benign tumors and malignant tumors were（4.96±0.61）and（5.56±0.88）,respectively(P＞0.05).The Cho/Cr values of benign tumors and malignant tumors were (1.05±0.25) and(2.76±0.54), respectively(P<0.05). The Cho/Cr value had sensitivity，specificity，and accuracy of84.6%，90%，and87.9%.Conclusions2D1H-MRS measured the increase Cho level in musculoskeletal tumorsmalignant tumor. Cho/Cr value is useful in distinguishing benign tumors from malignancies.MRS have more advantage than conventional MRI on distinguishing benign tumors frommalignancies.