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Vol. 9. Núm. 1.
Páginas 4-10 (enero 1998)
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Vol. 9. Núm. 1.
Páginas 4-10 (enero 1998)
Diagnóstico diferencial de tumores cerebrales “in vitro” por espectroscopía de resonancia magnética de protón. Método de los cocientes espectrales
Differential diagnosis of brain tumors by proton magnetic resonance spectroscopy “in vitro”. The method of spectroscopic ratios
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5189
J.Mª. Pascual, F. Carceller, J.M. Roda
Servicio de Neurocirugía. Hospital Universitario La Paz. 28046 Madrid
S. Cerdán*
* Instituto de Investigaciones Biomédicas del C.S.I.C. Madrid
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Resumen

Se han estudiado por espectroscopía de 1H RMN de alta resolución extractos de biopsias de cerebro humano normal (n=5), de astrocitomas de bajo grado (n=7), de astrocitomas de alto grado y glioblastomas (n=16), de meningiomas (n=18), de oligodendrogliomas (n=4) y de meduloblastomas (n=3). Los espectros obtenidos se compararon entre sí utilizando ocho cocientes de intensidad de resonancias específicas: colina/creatina, colina/N-acetilaspártico, creatina/N-acetilaspártico, colina/inositol, glutamina/glutamato, taurina/N-acetilaspártico, alanina/creatina y alanina/N-acetilaspártico. Estos cocientes permitieron realizar un, diagnóstico diferencial entre todos los tejidos estudiados con excepción de la comparación entre oligodendrogliomas y astrocitomas. Los tumores cerebrales pudieron diferenciarse del tejido cerebral normal por su menor contenido en N-acetilaspártico. Los meningiomas se caracterizaron por su alto contenido en alanina y los medulobiastomas por sus elevados contenidos en colina y taurina. En el caso de los astrocitomas fue posible discriminar entre los grados de malignidad bajo y alto en base al mayor valor del cociente colina/inositol y menor valor del cociente glutamina/glutamato en los astrocitomas de alto grado. Estos resultados indican que la aplicación de cocientes en la comparación de espectros de biopsias cerebrales constituye una herramienta útil en el diagnóstico diferencial de tumores por espectroscopía de’ 1H RMN.

Abreviaturas:
Ala
Cho
Cr
Glu
Gln
Gly
Ino
Lac
NAA
RMN
SNC
Tau
TSP
Palabras clave:
Espectroscopía 1H RMN, tumores cerebrales, diagnóstico in vitro:
Summary

We have studied high resolution 1H NMR spectra of extracts from biopsies of normal brain (n=5), low grade astrocytomas (n=7), high grade astrocytomas and glioblastomas (n=16), meningiomas (n=18), oligodendrogliomas (n=4) and medulloblastomas (n=3). The spectra were compared using eight different intensity ratios. of specific resonances: choline/creatine, choline/N-acetyl-aspartic, creatine/N-acetilaspartic, choline/inositol; glutamine/glutamate, turine/N-acetylaspartic, alanine/creatine and alanine/N-acetylaspartic. These ratios allowed a differential diagnosis for each of the tissue samples studied, with the exception of the comparison between oligodendrogliomas and astrocytomas. Brain tumors contained always less N-acetylaspartic than the normal brain. Meningiomas were characterized by their high content in alanine and medulloblastomas by their high content in choline and taurineo High grade astrocytomas and glioblastomas could be distinguished from low grade astrocytomas by their higher choline/inositol ratio and lower glutamine/glutamate ratio. These results indicate that comparisons between intensity ratios in spectra of cerebral biopsies provide a useful tool for the differential diagnosis of brain tumors by high resolution 1H NMR.

Key words:
1H NMR spectroscopy, brain tumors, in vitro diagnosis

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