The Value Of Quantification Of The Main Peak In Single-voxel ~1H Nuclear Brain Spectroscopy In Diagnosis Of Gliomas In Vivo At 3 T

objective:To explore the value of quantification of the main peak in single-voxel 1H nuclear brain spectroscopy in diagnosis of gliomas in vivo at 3T.Methods:From May to October in 2012,we exa-mined a total of 27 consecutive patients confirmed by pathology or clini-cally diagnosed with a variety of intracranial lesions.All proton MR spectroscopic studies were performed on a clinical 3.0T MR system(Philips,MR Systems Achieva,Dutch)with a sense-NV-16 phased array head coil.The VOI was placed in the solid part of the lesion.Quantificat?ion was obtained for N-acetyl-aspartate(NAA)level,creatine(Cr)level,choline(Cho)level and level of lipid(Lip).We assigned the peak height and peak area of NAA,Cho,Cr and lipid,respectively.Results to x-±s,a P value of less than 0.05 was considered to indicate a statistically signific-ant difference.Results:The study cohort consisted of 27 patients with the different diseases.Distribution normality tests were adopted about patie-nt's age,position of NAA,Cho,Cr,Lip,respectively,the results show that their mean were 49.3(years);2.017,3.217,3.034,1.288(ppm),respe-ctively,the descriptions are approximate normal.According to the patho-logical results,the patients were divided into glioma group and non-glio-ma group.Firstly,including meningioma and metastatic tumor group,the statistical analysis of the NAA,Cho,Cr,Lip of peak height and peak area found that the P value were 0.804 and 0.088(NAA);0,065 and 0.069(Cho);0.174 and 0.201(Cr);0.234 and 0.402(Lip),respectively.Secondly,excluding meningioma and metastatic tumor group,in the glioma group and the non-glioma group,the statistical analysis of the NAA,Cho,Cr,Lip of peak height and peak area found that the P value were 0.754 and 0.082(NAA);0,015 and 0.009(Cho);0.169 and 0.193(Cr);0.219 and 0.382(Lip),respectively,only Cho's peak height and peak area the difference was statistically significance:glioma group have higher Cho's peak height and peak area.And in the glioma group,the NAA,Cho,Cr and Lip of peak height and peak area under the Levene's Test for Equality of Variances and t test,respectively,all of the P value>0.05,can think approximate normal distribution.Firstly,including cases 6 and 9,the patients were divided into high-grade glioma group and low-grade glioma group,the statistical analysis of the NAA,Cho,Cr,Lip of peak height and peak area found that the P value were 0.804 and 0.088(NAA);0,065 and 0.069(Cho);0.174 and 0.201(Cr);0.234 and 0.402(Lip),respe-ctively.Secondly,excluding cases 6 and 9(because they had a clear history of glioma surgery and they are treated before examination),the P value were 0.398,0.233(NAA);0.551,0.987(Cho);0.413,0.810(Cr);0.016,0.078(Lip),only the Lip's peak height(P values<0.05)was statistically significance:high-grade glioma group have higher Lip's peak height.Conclusions:(1).Clear image is used to help diagnose intracranial lesions completely feasible in 3.0T single-voxel 1H nuclear brain spec-troscopy in vivo.(2)NAA is the preferred marker of nerve cells,the destruction of neurons,axonal injury,mitochondrial dysfunction in nerve cells can lead to different degrees of decline in the NAA peak height and peak area.In 2.017ppm of the NAA peak height and peak area were not statistically significant between glioma groups and non-glioma groups,low-grade gliomas and high-grade glioma groups.(3).Excluding menin-gioma,metastases group,glioma and non-glioma were identified by 3.217 ppm at the the Cho peak height and peak area:the glioma group have higher Cho peak height and peak area.(4).Cr is the energy meta-bolism markers in brain,the changes in its concentration is dynamic:increase energy hypo-metabolism and reduce energy hypermetabo-lism.The decline of the peak is not a specific marker of neuron dysfunction.In 3.034 ppm Cr peak height and peak area were not statistically significant between glioma group and non-glioma group,low-grade gliomas and high-grade glioma group.(5).Excluding cases after clinical treatment,glioma was precisely identified by 1.288 ppm at the the Lip peaks height:the high-grade glioma group(III,grade IV)have higher Lip peak height.