目的通过分析原发颅内弥漫大 B细胞淋巴瘤(DLBCL)术前1 H-MRS与术后病 理的相关性，评价MR波谱在DLBCL预后评 估中的应用价值。方法 回顾性分析经手 术病理证实的11例原发颅内DLBCL患者的 MRI、1 H-MRS及病理资料。分析肿瘤的部 位、形态、信号等特点；定量测量肿瘤 实质区和对照脑实质区各代谢物(Cho、 Cr、NAA)波峰下面积和峰高比值(NAA/ Cr、Cho/Cr、Cho/NAA)，采用配对t检验 比较两组间差异；对肿瘤实质区的Cho峰 下面积与免疫组化Ki-67表达水平进行 Spearman相关性分析。结果 11例原发颅 内DLBCL均表现为肿瘤实质区Cho峰升高， NAA峰及Cr峰减低，并可见Lip峰，Cho/Cr 及Cho/NAA比值升高，NAA/Cr比值减低。 统计分析表明，除Cr外，肿瘤实质区与 对照脑实质区各代谢物及比值的差异均 具有统计学意义(P<0.05)。Spearman相 关分析显示，肿瘤实质区Cho峰下面积与 Ki-67表达水平呈正相关关系(rs=0.627， P=0.039)。结论 1 H-MRS对原发颅内DLBCL 的术前诊断具有重要作用，在肿瘤预后评 估中亦有较大应用价值。

Objective To evaluate the application value of 1 H-MRS in assessing prognosis of primary intracranial diffuse large B-cell lymphoma (DLBCL) by comparing 1 H-MRS with pathology result. Methods MRI features, 1 H-MRS and pathology results of 11 intracranial DLBCL were retrospectively analyzed. Tumor location, appearance and signal were analyzed. Cho, Cr, NAA, NAA/Cr, Cho/Cr, Cho/NAA values of the tumor solid part and contralateral brain parenchyma were measured. Paired sample T test was used to compare the tumors and control brain parenchyma. Correlation of Cho and Ki-67 was analyzed with Spearman analysis. Results All 11 cases showed raised Cho, Cho/Cr and Cho/NAA, and decreased NAA, Cr and NAA/Cr. The statistical analysis demonstrated that all except Cr had statistical significance (P<0.05) between tumor solid region and compared normal brain. Spearman correlation analysis showed positive correlation between Cho and the expression level of Ki-67 (rs=0.627, P=0.039). Conclusion 1 HMRS has played an important role in preoperative diagnosis of intracranial DLBCL, it also could be used as an useful tool for assessing prognosis.