アベ カヨコ   ABE Kayoko
  阿部 香代子
   所属   医学部 医学科(東京女子医科大学病院)
   職種   講師
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Proton magnetic resonance spectroscopy differentiates tumefactive demyelinating lesions from gliomas.
掲載誌名 正式名:Multiple sclerosis and related disorders
略  称:Mult Scler Relat Disord
ISSNコード:22110356/22110348
掲載区分国外
巻・号・頁 26,pp.77-84
著者・共著者 Ikeguchi Ryotaro†, Shimizu Yuko*, Abe Kayoko, Shimizu Satoru, Maruyama Takashi, Nitta Masayuki, Abe Koichiro, Kawamata Takakazu, Kitagawa Kazuo
発行年月 2018/11
概要 BACKGROUND:It is often difficult to accurately differentiate tumefactive demyelinating lesions (TDLs) from gliomas using MRI.OBJECTIVE:To investigate the utility of proton magnetic resonance spectroscopy (MRS) in differentiating TDLs from gliomas.METHODS:Cohort 1 included 6 patients with TDLs and 5 with gliomas (3 high-grade), as assessed using a 1.5T MR unit. Cohort 2 included 6 patients with TDLs and 17 patients with gliomas (8 high-grade), as assessed using a 3.0T MR unit. Single-voxel proton MRS was performed to compare the following metabolite area ratios: choline (Cho)/creatine (Cr), N-acetylaspartate (NAA)/Cr, and Cho/NAA in both cohorts. Correlations between the target-to-normal-tissue ratio (TNR) obtained using methionine-positron emission tomography (MET-PET) and each MRS metabolite ratio were examined in a subset of cohort 2 (4 patients with TDLs and 11 with gliomas).RESULTS:Mean Cho/NAA ratio was significantly higher in gliomas than in TDLs or MS in cohort 1 (p < 0.05). Mean Cho/NAA ratio was significantly higher in high-grade gliomas than in TDLs in both cohorts (ps < 0.05). In the receiver operating characteristic analysis, high-grade glioma rather than TDL was indicated when the Cho/NAA ratio was >1.72 (the area under the curve was 0.958, and the maximum sensitivity and specificity were 100% and 87%, respectively). A significant positive correlation was observed between Cho/NAA ratio and the MET-PET TNR (r2 = 0.35, p < 0.05).CONCLUSION:MRS effectively differentiates TDLs from high-grade gliomas. Therefore, the clinical use of MRS is likely to enhance patient outcomes.
DOI 10.1016/j.msard.2018.08.025
PMID 30237108