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首页> 外文期刊>British journal of neurosurgery >Recognition of anaplastic foci within low-grade gliomas using MR spectroscopy
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Recognition of anaplastic foci within low-grade gliomas using MR spectroscopy

机译：MR波谱法识别低度胶质瘤内的间变性灶

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Background. The recognition of anaplastic foci within low-grade gliomas is of extreme importance in patients under follow-up for Grade II gliomas. We present the algorithm of MR spectroscopy (MRS)-guided brain biopsy and its correlation with tumour histology. Methods. Twenty-seven patients harbouring suspected Grade II/III glioma were examined on our 3T MR. 2D PRESS-CSI metabolite images of Choline/Creatine, Creatine/N-acetylaspartate and Choline/N-acetylaspartate were calculated and exported to the DICOM format. According to these maps, a stereobiopsy was performed at the point of maximum Choline/Creatine ratio prior to tumour resection. In the case of enhancing tumour, a subsequent biopsy was performed from the point of enhancement. Comparisons were made between the histology of the biopsied specimens and the resected tumours. Results. Eleven tumours were diagnosed as high-grade and sixteen as low-grade lesions. The correlation between main spectroscopic ratios (Cho/Cr and Cho/NAA) was strongly positive at the points of maximum Cho/Cr. Similar results were obtained at the points of contrast enhancement. Comparison of histological parameters of biopsy samples at the points of maximum Cho/Cr and histological examination of the completely resected tumours gives a strong correlation of tumour grade, number of mitoses and Ki-67 expression. The diagnostic accuracy of MRS-guided biopsy was 84%. The absolute value of Cho/NAA was higher in high-grade compared to that of low-grade lesions. The value of Cho/NAA ratio of 0.9 using MRS produced a sensitivity and specificity of 78% in the differentiation between low-grade and high-grade lesions. Combining MRS with structural MR, the sensitivity increased to 86% and the specificity to 80%. Conclusions. Strong correlation was demonstrated between Cho/Cr and Ch/NAA ratios. Strong correlation was demonstrated between histological parameters of biopsy samples taken using Cho/Cr ratio and those from total tumour examination. Diagnostic accuracy of MRS-guided biopsy was 84%. Sensitivity and specificity of MRS combined with structural MR reaches 86% and 80%.
机译：背景。在II级神经胶质瘤的随访患者中，低级神经胶质瘤中变性变性灶的识别极为重要。我们提出了磁共振波谱（MRS）指导的脑活检的算法及其与肿瘤组织学的关系。方法。在我们的3T MR上检查了27位疑似II / III级神经胶质瘤的患者。计算胆碱/肌酸，肌酸/ N-乙酰天冬氨酸和胆碱/ N-乙酰天冬氨酸的2D PRESS-CSI代谢物图像，并将其导出为DICOM格式。根据这些图，在肿瘤切除之前，在最大胆碱/肌酸比的点进行了活检。在增强肿瘤的情况下，从增强的角度进行随后的活检。在活检标本的组织学和切除的肿瘤之间进行比较。结果。诊断为高级别的肿瘤为11例，低级别的肿瘤为16例。主要光谱比（Cho / Cr和Cho / NAA）之间的相关性在最大Cho / Cr的点上呈强正相关。在对比度增强点获得了相似的结果。比较最大Cho / Cr点处的活检样本的组织学参数和完全切除的肿瘤的组织学检查，可以得出肿瘤等级，有丝分裂数和Ki-67表达的强烈相关性。 MRS引导的活检的诊断准确性为84％。与低级别病变相比，高级别Cho / NAA的绝对值更高。使用MRS得出的Cho / NAA比值为0.9，在区分低度和高度病变方面产生了78％的敏感性和特异性。将MRS与结构MR结合使用，灵敏度提高到86％，特异性提高到80％。结论在Cho / Cr和Ch / NAA比之间显示出很强的相关性。在使用Cho / Cr比获取的活检样本的组织学参数与来自全肿瘤检查的组织学参数之间显示出强相关性。 MRS引导的活检的诊断准确性为84％。 MRS结合结构性MR的敏感性和特异性分别达到86％和80％。

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