[1]钟华,代海洋,李丽红,等.1.5T磁共振1H-MRS鉴别良恶性胸腔积液的初步研究[J].国际放射医学核医学杂志,2015,39(4):292-294,299.[doi:10.3760/cma.j.issn.1673-4114.2015.04.004]
　Zhong Hua,Dai Haiyang,Li Lihong,et al.A preliminary study of 1H-MRS in diagnosis of benign and malignant pleural effusions[J].International Journal of Radiation Medicine and Nuclear Medicine,2015,39(4):292-294,299.[doi:10.3760/cma.j.issn.1673-4114.2015.04.004]
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《国际放射医学核医学杂志》[ISSN:1673-4114/CN:12-1381/R]

卷:
39
期数:
2015年第4期
页码:
292-294,299
栏目:
出版日期:
2015-07-25

文章信息/Info

Title:
A preliminary study of 1H-MRS in diagnosis of benign and malignant pleural effusions
作者:
钟华1;  代海洋1;  李丽红1;  肖叶玉2;  吴仁华2
1. 惠州市中心人民医院放射科, 惠州, 516001;
2. 汕头大学医学院第二附属医院影像科, 惠州, 515041
Author(s):
Zhong Hua1;  Dai Haiyang1;  Li Lihong1;  Xiao Yeyu2;  Wu Renhua2
Department of Radiology, HuiZhou Municipal Central Hospital, Huizhou 516001, China
关键词:
胸腔积液; 磁共振波谱学
Keywords:
Pleural effusion; Magnetic resonance spectroscopy
DOI:
10.3760/cma.j.issn.1673-4114.2015.04.004
摘要:
目的 探讨磁共振波谱对良、恶性胸腔积液的鉴别诊断价值。方法 收集行胸腔穿刺抽液的胸腔积液标本46例,其中原发病确诊为良性者20例(包括肺结核14例、肺炎6例),原发病确诊为恶性者26例(包括原发性肺癌18例、乳腺癌5例、肝癌2例、胃癌1例)。对胸腔积液标本进行离心处理,然后利用1.5T磁共振对胸腔积液标本进行波谱采集,分析良恶性胸腔积液的波谱特征。结果 胸腔积液的波谱图中主要的代谢峰有乳酸、胆碱、肌酸、肌醇及脂质等。主要代谢物波峰下面积比较:乳酸:结核性(5.19±1.31)、炎性(6.08±1.56)和恶性胸腔积液(2.40±0.43)的乳酸峰下面积差异有统计学意义(F=8.45,P<0.01);胆碱:结核性(2.75±0.91)、炎性(3.27±1.21)和恶性胸腔积液(6.76±1.73)的胆碱峰下面积差异有统计学意义(F=2.98,P<0.01);肌醇:结核性(2.71±1.19)、炎性(2.25±0.81)和恶性胸腔积液(5.83±2.08)的肌醇峰下面积差异有统计学意义(F=38.49,P<0.01)。结核性和炎性胸腔积液中乳酸(t=-1.04,P>0.05)、胆碱(t=-0.58,P>0.05)和肌醇(t=1.19,P>0.05)波峰下面积差异无统计学意义。结论 良、恶性胸腔积液具有不同的波谱特征,利用磁共振波谱对良、恶性胸腔积液进行鉴别具有一定的临床应用价值。
Abstract:
Objective To investigate the feasibility of magnetic resonance spectroscopy (MRS) in the diagnosis of benign and malignant pleural effusions.Methods Samples of 46 cases of pleural effusion were collected in clinics after performing pleurocentesis.Among the obtained samples,20 cases were benign pleural effusion (14 cases of tuberculosis and 6 cases of pneumonia) and 26 cases were malignant pleural effusion (18 cases of primary bronchogenic carcinoma,5 cases of breast carcinoma,2 cases of primary hepatic carcinoma,and 1 case of gastric carcinoma).The effusion pleural samples were centrifuged and subjected to 1H MRS examination using a 1.5T MR device.Results The main metabolites in the pleural effusion contain lactate,choline,creatine,myo-inositol (MI),and fatty acids.Area of Lactate:pleural effusion from tuberculosis (5.19±1.31),pneumonia (6.08±1.56) and malignant pleural effusion (2.40±0.43) has statistic significance (F=8.45,P<0.01).Area of choline:pleural effusion from tuberculosis (2.75±0.91),pneumonia (3.27±1.21) and malignant pleural effusion (6.76±1.73) has statistic significance (F=2.98,P<0.01).Area of MI:pleural effusion from tuberculosis (2.71±1.19),pneumonia (2.25±0.81) and malignant pleural effusion (5.83±2.08) has statistic significance (F=38.49,P<0.01).Area of lactate (t=-1.04,P>0.05),choline (t=-0.58,P>0.05) and MI (t=1.19,P>0.05) between pleural effusion from tuberculosis (5.19±1.31) and pneumonia has no statistic significance.Conclusions Benign and malignant pleural effusions show different MRS characteristics.1H MRS has certain clinical value in the differentiation of benign and malignant pleural effusions.

参考文献/References:

[1] 孙家兴, 于文成, 胡海燕, 等. 恶性胸腔积液与结核性胸腔积液的诊断进展[J]. 现代生物医学进展, 2013, 13(14):2780-2789.
[2] 刘津梅, 尹瑞玲. 结核性与癌性胸腔积液的超声鉴别诊断[J]. 天津医科大学学报, 2010, 16(4):671-673.
[3] 张国庆, 朱庆华, 常利明. 检测胸腔积液和血清中肿瘤标记物在良恶性胸腔积液鉴别诊断中的临床价值[J]. 中国实验诊断学, 2013, 4(20):852-854.
[4] 凡瞿明, 罗关成, 卢小岚, 等. 肿瘤标记物联合检测诊断恶性胸腔积液的应用价值[J]. 国际检验医学杂志, 2013, 4(10):415-417.
[5] 韩志江, 陈文辉, 叶健. 结核性胸腔积液和恶性胸腔积液鉴别中CT值的应用[J]. 中国实用内科杂志, 2006, 12(S2):S128-129.
[6] 马凤, 张志远, 贾永军, 等. 宝石能谱CT在结核性胸腔积液和癌性胸腔积液鉴别诊断中的应用[J]. 中国医学影像学杂志, 2013, 21(5):360-362.
[7] 辛小燕, 朱斌, 陈君坤, 等. CT能谱成像在胸腔渗出液与漏出液定性鉴别中的作用[J]. 中华放射学杂志, 2011, 45(8):723-726.
[8] Kim BS, Kim IJ, Kim SJ, et al. Predictive value of F-18 FDG PET/CT for malignant pleural effusion in non-small cell lung cancer pa-tients[J]. Onkologie, 2011, 34(6):298-303.
[9] 冯恩志, 戚好文, 薛军. 胸水淋巴细胞微核率检测在良、恶性胸腔积液鉴别诊断中的意义[J]. 第四军医大学学报, 2002, 23(6):549-551.
[10] Husarova V, Bittsansky M, Ondrejka I, et al. Correlations of ADHD symptoms with neurometabolites measured by 1H magnetic reso-nance spectroscopy[J]. Bratisl Lek Listy, 2014, 115(10):635-642.
[11] Haris M, Cai K, Singh A, et al. In vivo mapping of brain myo-inosi-tol[J]. Neuroimage, 2011, 54(3):2079-2085.

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备注/Memo

备注/Memo:
收稿日期:2015-03-03。
通讯作者:钟华,Email:gdhz_zhong_h@163.com
更新日期/Last Update: 1900-01-01