首页> 外文期刊>Journal of clinical neuroscience: official journal of the Neurosurgical Society of Australasia >Targeting regions with highest lipid content on MR spectroscopy may improve diagnostic yield in stereotactic biopsy.
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Targeting regions with highest lipid content on MR spectroscopy may improve diagnostic yield in stereotactic biopsy.

机译:MR光谱学上靶向脂质含量最高的区域可以提高立体定向活检的诊断率。

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摘要

Gliomas are heterogeneous brain tumors and prognosis and treatment are dependent on the highest histological grade present. Stereotactic biopsy is associated with an inherent risk of sampling error. Magnetic resonance spectroscopy (MRS) uses clinical MR scanners to provide chemical in addition to conventional information. MRS studies in brain tumors have found increased levels of choline-containing compounds (Cho) and decreased levels of N-acetylaspartate (NAA), creatine (Cr) and phosphocreatine (PCr) which are all associated with increased grade of glioma. We propose the use of MRS-guided stereotactic biopsy of astrocytomas to increase diagnostic yield and reduce the sampling error rate. MRS was performed on two patients undergoing stereotactic biopsy for suspected astrocytoma. Spectral peak heights of the metabolites Cho at 3.2 parts per million (ppm) chemical shift, NAA at 2.0 ppm and lipid (Lip) at 1.2 ppm, were measured. Biopsy targets were selected from the voxels with the highest Cho/NAA and normalised against Cho levels in the contralateral normal tissue, as well as those with highest lipid content. The biopsies were taken and tissue diagnosis was obtained via standard histological techniques. Histological grade was found to be different in one case: the region with a high Lip/Cr and Cho/NAA ratios showed glioblastoma, whereas the region with high Cho/NAA but low Lip/Cr ratios showed anaplastic astrocytoma. The second patient had high Cho/NAA ratio but low Lip/Cr ratio in both targets and the histology revealed anaplastic astrocytoma in both samples. MRS is a useful biomedical imaging tool for diagnosing and grading astrocytomas. Targeting regions with highest lipid content can potentially improve the diagnostic yield and minimize sampling error in stereotactic biopsy.
机译:神经胶质瘤是异质性脑肿瘤,预后和治疗取决于目前的最高组织学等级。立体定向活检与取样误差的固有风险有关。磁共振波谱(MRS)除了常规信息外,还使用临床MR扫描仪提供化学药品。在脑肿瘤中进行的MRS研究发现,含胆碱的化合物(Cho)含量升高,N-乙酰天门冬氨酸(NAA),肌酸(Cr)和磷酸肌酸(PCr)含量降低,这些都与神经胶质瘤等级的升高有关。我们建议使用MRS指导的星形细胞瘤立体定位活检,以提高诊断率并降低采样错误率。对两名因立体星形细胞瘤进行立体定位活检的患者进行了MRS。测量了代谢物Cho在百万分之3.2的化学位移,NAA在2.0 ppm的脂质和脂质(Lip)在1.2 ppm的光谱峰高。从具有最高Cho / NAA的体素中选择活检目标,并针对对侧正常组织以及具有最高脂质含量的那些进行标准化以针对Cho水平。进行活检并通过标准组织学技术获得组织诊断。在一种情况下,发现组织学等级不同:Lip / Cr和Cho / NAA比值高的区域显示胶质母细胞瘤,而Cho / NAA高但Lip / Cr比值低的区域显示变性间质细胞瘤。第二名患者在两个靶标中均具有较高的Cho / NAA比,但其Lip / Cr比例均较低,并且组织学显示两个样品均存在间变性星形细胞瘤。 MRS是诊断和分级星形细胞瘤的有用的生物医学成像工具。具有最高脂质含量的靶向区域可以潜在地提高诊断产量,并使立体定位活检中的采样误差最小化。

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