中文摘要：

目的探讨多体素氢质子磁共振波谱（^1H-MRS）在鉴别高、低级别脑胶质瘤中的作用。方法连续纳入2015年1月至2015年12月在首都医科大学附属北京天坛医院神经外科经病理学诊断为脑胶质瘤的患者53例，其中低级别组29例，高级别组24例。术前采用西门子Prisma3．0T磁共振扫描仪行常规磁共振扫描和^1H-MRS扫描。根据^1H-MRS结果获得肿瘤侧和对侧相同部位（健侧）感兴趣区的胆碱（Cho）／N-乙酰天门冬氨酸（NAA），比较两组的Cho／NAA均值和最大值比值。采用受试者工作特征（ROC）曲线分析Cho／NAA值评估胶质瘤级别的效能。结果与同组健侧相同区域比较，高、低级别组肿瘤实质区的Cho／NAA均值均明显增高，差异有统计学意义（均P〈0．001）。与低级别组比较，高级别组肿瘤实质Cho／NAA的最大值比值、Cho／NAA均值以及肿瘤侧与健侧Ch/NAA均值的比值均增高，差异均有统计学意义（均P〈0．01）。ROC曲线分析显示，肿瘤实质Cho/NAA最大值比值、Cho／NAA均值、肿瘤侧与健侧Cho／NAA均值的比值诊断不同级别脑胶质瘤的曲线下面积分别为0．7938（敏感度和特异度分别为54．6％和92．9％）、0．7581（敏感度和特异度分别为59．1％和78．6％）及0．7386（敏感度和特异度分别为45．5％和92．9％）。结论多体素^1H-MRS检测Cho／NAA对鉴别低级别及高级别脑胶质瘤有临床应用价值。

英文摘要：

Objective To investigate the roles of multi-voxel proton magnetic resonance spectroscopy for identifying low- and high-grade gliomas. Methods From January 2015 to December 2015, 53 consecutive patients with brain glioma diagnosed pathologically at the Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University were enrolled. There were 29 patients in the low-grade group and 24 in the high-grade group. SIEMENS Prisma 3 T magnetic resonance scanner performed conventional magnetic resonance scanning and ^1H-MRS scanning before procedure. The choline （Cho）/N- acetyl aspartate （NAA） of the region of interest at same parts of the side of tumor and contralateral side （ unaffected side） was obtained according to the ^1H-MRS results. The ratios of mean values of Cho/NAA and the maximum values in both groups were compared. Receiver operating characteristic （ROC） curve was used to analyze the Cho/NAA value and assess the efficiency of glioma grade. Results Compared with contralateral same area of the same group, the mean value of Cho/NAA in the tumor parenchyma areas of the low- and high-grade groups increased significantly. There was significant difference （ all P 〈 0. 001 ）. Compared with the low-grade group, the maximum ratio, mean value, side of tumor and the ratio of eontralateral Cho/NAA mean values of the tumor parenchyma Cho/NAA in the high-grade group were all increased. There were significant differences （ all P 〈 0.01 ）. The ROC curve analysis showed that the Cho/ NAA maximum ratio of tumor parenchyma, the mean value of Cho/NAA, the ratios of the mean values of the side of tumor and contralateral Cho/NAA for diagnosis of the area under the curve of the different grade gliomas were 0. 7938 （ the sensitivity and specificity were 54.6% and 92.9% respectively） and 0. 7581 （the sensitivity and specificity were 59.1% and 78.6% respectively）, and 0. 7386 （the sensitivity and specificity were 45.5% and 92.9% respectively）. Conclusion ^1H-MRS detection of Cho/NA