中文摘要：

目的利用高分辨魔角旋转质子磁共振波谱（HRMAS-1H MRS）检测脑肿瘤手术标本,分析胶质瘤及脑膜瘤水溶性代谢物特征,探讨HRMAS-1H MRS临床应用价值.方法 30例病理证实脑肿瘤,6例Ⅰ～Ⅱ级星形细胞瘤,7例间变（Ⅲ级）星形细胞瘤,10例胶质母细胞瘤（Ⅳ级）和7例脑膜瘤.Varian公司600 MHz谱仪上Nano探头采集HRMAS-1H MRS,jMRUI 3.2版软件处理,总结代谢物出现几率,比较代谢物与Cr比值.结果①HRMAS-1H MRS能分辨NAA、PCr/Cr、GPC＋PCho＋Cho、Glu/Gln、Gly、Tau、Ala、Lac、mI等脑内多种代谢物.所有样本均显示Lac峰,6例样本在3.72 ppm或3.90 ppm处显示一组不知名的单峰.②6例Ⅰ～Ⅱ级星形细胞瘤Cho/Cr （2.42±1.01）,与胶质母细胞瘤组比较P＝0.003;7例间变性星形细胞瘤Cho/Cr （3.48±0.59）,与胶质母细胞瘤组比较P＝0.01;10例胶质母细胞瘤Cho/Cr变化范围大,从0.9～11.3,平均值（5.40±1.23）.从Ⅰ～Ⅱ级星形细胞瘤到胶质母细胞瘤Gly、Tau、mI、Ala出现几率增加,Ala/Cr、Tau/Cr和Gly/Cr有升高趋势;胶质瘤Ala/Cr （0.31±0.13）.③脑膜瘤Ala峰和Cho峰较高,Cr峰较胶质瘤下降.4例无NAA峰,3例有较低NAA峰.Cho/Cr （3.56±1.01）;Ala/Cr （0.53±0.28）,与胶质瘤比较P＝0.006.结论 HRMAS-1H MRS能进一步显示波谱细节,分辨活体波谱中Cho峰下代谢物,显示胶质瘤良恶性程度.随着恶性程度增加,Cho、mI、Ala、Tau、Gly增加.HRMAS-1H MRS是惟一能得到病理标本各项同性波谱的方法.

英文摘要：

Objective To detect specimens of brain tumors with high resolution magic angle spinning 1-Hydrogen MR spectroscopy （HRMAS-^1H MRS）, to analyze their soluble metabolites, and discuss its clinical value. Methods There were 30 brain tumors confirmed by pathology, including Ⅰ-Ⅱ graded astrocytomas （n= 6）, Ⅲ graded astrocytomas （n= 7）, glioblastomas （n= 10）, meningiomas （n= 7）. All data were obtained with 600 MHz spectrometer and analyzed on jMRUI software. Results ① HRMAS-^1H MRS could resolve lots of metabolites, such as NAA, PCr /Cr, GPC＋PCho＋Cho, Glu/Gln, Gly, Tau, Ala, Lac, mI, etc. All samples had Lac peak. 6 samples showed unknown peak at 3.72 ppm or 3.90 ppm. ② The ratio of Cho/Cr to Ⅰ-Ⅱ astrocytomas was （2.42±1.01）, compared with glioblastomas （5.40± 1.23）, P= 0. 003. The ratio of Cho/Cr to 11 astrocytomas was （3.48±0.59）, compared with glioblastomas, P=0.01. From Ⅰ-Ⅱ astrocytomas to glioblastoma, the detected opportunities of Gly, Tau, mI and Ala were more and more. The values of Ala/ Cr, Tau/Cr and Gly/Cr were elevated. The ratio of Ala/Cr to gliomas was （0. 31 ±0. 13）. ③ In meningiomas, 4 cases showed no NAA, 3 cases presented NAA. The ratio of Ala/Cr was （0. 53±0.28）, compared with gliomas, P= 0. 006. Conclusion HRMAS-± H MRS can show more detail spectrum, resolve ingredients of the Cho compound and graded degree of gliomas. With the malignancy of gliomas rising, Cho, mI, Ala, Tau and Gly may elevate. HRMAS-^1H MRS is the only method which is able of acquiring isotropic spectroscopy of solid samples.