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BACKGROUND AND PURPOSE: Diffusion-weighted imaging (diffusion weighted imaging, DWI) with the magnetic resonance imaging (magnetic resonance imaging, MRI) hardware and software advances, new imaging techniques and scanning sequence emerging and magnetic resonance spectroscopy (magnetic resonance spectroscopy , MRS) and the emergence and bring a new dawn for the clinical diagnosis and differential diagnosis of brain diseases. DWI is the only way the current on the human body of water diffusion measurement and imaging can reflect the organization's internal characteristics of the microstructure and the microscopic motion, but also reflect the unique information of the state of brain function at the molecular level. MRS is a method for quantitative analysis of specific nuclei and the human body compounds using magnetic resonance phenomena and chemical shift (chemical shift, CS) role, and is the only non-invasive detection of metabolic changes in non-invasive imaging techniques. Intracranial cystic lesions (intracranial cystic diseases, ICD) is a common group of serious harm to human health, including necrotic or cystic brain tumor (necrotic-cystic intracranial tumor, N / CIT), brain abscess (brain abscess, BA) cerebral cysticercosis (cerebral cysticercosis, CC), epidermoid cyst (epidermoid cysts, EC), arachnoid cyst (arachnoid cyst, AC) and other diseases. The ICD's DWI and H-MRS (proton magnetic resonance spectroscopy, 1 H-MRS) research is research hotspot of Chinese and foreign scholars. Despite conventional CT, conventional SE sequences T 1 WI T 2 WI, enhanced scan T 1 WI sequences, fluid-attenuated inversion recovery ( fluid attenuated inversion recovery, FLAIR) sequences, the majority of ICD to make the right diagnosis, but still part of the ICD preoperative correct diagnosis is difficult. In view of this, the purpose of this project is to sweep with magnetic resonance level T 1 the flair and T 2 WI comparison, evaluation the DWI and 1 H-MRS ICD diagnostic value. Materials and Methods: collected from October 2005 to March 2007, were confirmed by pathology or clinical follow-up confirmed 76 cases of intracranial cystic lesions of patients using the GE Signa 1.5T MRI scanner, both T 1 flair, T 2 WI, DWI check where the the 65 routine monomer prime or multi-voxel 1 H-MRS examination. 76 patients, 37 cases of necrotic or cystic degeneration of brain tumors, brain abscess, 12 cases, 5 cases of cerebral cysticercosis, epidermoid cyst in 10 cases, 12 cases of arachnoid cyst. Necrotic or cystic degeneration of the tumor, astrocytoma in 16 cases (1 case of grade astrocytoma I, class II three cases, 5 cases of grade Ⅲ, Ⅳ grade 7 cases), 12 cases of metastatic tumors, four cases of acoustic neuroma, meningioma three cases, two cases of hemangioblastoma. DWI SE-EPI sequence expansion operator the sensitive coefficient b value (b value) using 0s/mm 2 and 1000s/mm 2 ; single voxel (single voxel, SV ) or multi-voxel (multi voxel MV) 1 H-MRS check PRESS (point-resolved spectroscopy, PRESS) sequence. Measurement and / or calculation of DWI and 1 H-MRS analysis indicators. The results of experiments are presented as mean ± standard deviation ((?) ± s) said, using two-sample t-test of the mean difference between the three groups using One-way ANOVA, and statistical analysis application SPSS11.5 software package for data processing, α = 0.05 level of inspection. Results: (1) 76 cases of intracranial cystic lesions DWI clearly demonstrated that 70 (92.1%), while the T 2 WI and T , 1 flair sequence of 76 cases of intracranial cystic lesions were clearly demonstrated in 65 patients (85.5%), the difference was not statistically significant (P> 0.05); 76 cases of intracranial cystic lesions DWI only eight cases of lesions perifocal edema (10.5%), while T < sub> 2 WI and T 1 and flair clearly shows that the 49 lesions perifocal edema (64.5%), the difference was statistically significant (P <0.01). Cystic lesions DWI the four signal performance: I type DWI high signal ADC value compared with contralateral high 19 cases; II type DWI high signal ADC value lower than the contralateral four cases; the III type DWI Low signal ADC value compared with the contralateral 44 cases; Ⅳ the DWI mixed signal ADC value is higher than the contralateral nine cases. (2) 16 cases of astrocytoma, 12 cases of metastatic tumors, four cases of acoustic neuroma cystic areas and five cases of cerebral cysticercosis mean ADC values ??were (1.412 ± 0.689) × 10 -3 mm 2 / s, (1.313 ± 0.750) × 10 -3 mm 2 / s, (1.316 ± 0.351) × 10 -3 < / sup> mm 2 / s and (1.250 ± 0.680) × 10 -3 mm the 2 / s, astrocytoma, metastatic tumor , listen to the neuroma cystic areas and cerebral cysticercosis and control side corresponding brain tissue ADC value statistics are significant with difference (P <0.01); astrocytoma, metastasis tumor and listen to the neuroma cystic ADC value variance analysis without significantly with difference (P> 0.05). Astrocytoma, cystic metastases and cerebral cysticercosis analysis of variance among the three groups ADC values ??was not statistically significant (P = 0.146); astrocytoma metastases cystic areas and cerebral cysticercosis ADC value twenty-two no statistical significance (P> 0.05). (3) Ⅰ the II grade astrocytoma tumor patients with cystic average ADC value (1.631 ± 0.218) x 10 -3 mm the 2 / s Ⅲ ~~, Ⅳ grade astrocytoma and 12 cases of cystic mean ADC value (1.157 ± 0.162) x 10 -3 mm the 2 / s Ⅰ to Ⅱ grade astrocytoma tumor ADC values ??higher than Ⅲ ~ Ⅳ grade astrocytoma ADC values ??(P <0.01); different grade astrocytomas ADC values ??corresponding with the control side of the brain tissue ADC value statistical significant difference (P <0.01) . (4) 37 -3 mm 2 / s, peritumoral edema, necrotic or cystic degeneration of the tumor parenchyma mean ADC value (1.32 ± 0.109) × 10 mean ADC value (1.80 ± 0.115) × 10 -3 mm 2 / s, the cystic necrosis District average ADC value (2.48 ± 0.156) × 10 -3 mm 2 / s, a substantial part of the tumor, peritumoral edema, necrosis, cystic area ADC values ??among the three groups analysis of variance significant difference (P <0.01). (5) brain abscess (pus cavity) 12 cases mean ADC value (0.63 ± 0.199) × 10 -3 mm 2 / s, necrotic or cystic tumor cystic area 10 -3 mm the ADC value (2.48 ± 0.156) x 2 / S brain abscess ADC value lower than that of the control side corresponding brain tissue, and statistically significant difference (P <0.01), the brain abscess ADC value was significantly lower than the the tumor cystic ADC values ??(P <0.01). (6) 10 cases of epidermoid cyst mean ADC value (1.21 ± 0.993) x 10 -3 mm the 2 / s, arachnoid cyst ADC value (2.98 ± 0.232 ) × 10 -3 mm 2 / s, epidermoid cyst mean ADC value higher than the corresponding to the control side of the brain tissue (0.94 ± 0.049) × 10 -3 < / sup> mm 2 / s, and a statistically significant difference (P <0.01), arachnoid cyst ADC value was significantly higher than that corresponding to the control side of the brain tissue (0.90 ± 0.064) x 10 -3 mm 2 / s, and a statistically significant difference (P <0.01), ADC value was significantly lower than epidermoid cyst, arachnoid cyst (P <0.01). (7) 1 H-MRS in 37 cases of necrotic or cystic the cystic degeneration tumor area were observed in the low NAA, Cho, Cr peak observed 17 cases of Lac peak, 12 cases see Lip peak . 10 cases of brain abscess see Ace AA peak and Lac peaks, five cases, 6 cases of Suc, Ala at 6 cases of 4 cases of Glu peak. Five cases of cerebral cysticercosis see Lac peak, Suc peak, Ace peaks and Ala peak. 5 cases of epidermoid cyst Lac peak. Six cases of arachnoid cyst, three cases show only low Lac peak. (8) a substantial part of the control side of cystic degeneration of the tumor necrosis corresponding brain tissue metabolites NAA (236.17 ± 130.46) and (670.23 ± 128.34), Cho (782.57 ± 212.32) and (538.72 ± 142.09), the ratio of NAA / Cr (0.92 ± 0.41), respectively, Cho / Cr (1.52 ± 0.38), the differences were statistically significant (P <0.01); brain abscess wall with the control side corresponding brain tissue metabolites NAA (368.10 ± 112.42) and (845.13 ± 228.16), Cho (782.57 ± 212.32) and (723.00 ± 154.19), and the differences were statistically significant (P <0.01). Brain abscess wall with the control side corresponding brain tissue metabolites NAA / Cr (1.28 ± 0.61) and (1.42 ± 0.18), Cho / Cr (1.79 ± 1.22) and (1.23 ± 0.38), the difference was not statistically significant (P> 0.05). (9) necrotic or cystic degeneration of the tumor parenchyma and brain abscess wall metabolites NAA (236.17 ± 130.46) and (368.10 ± 112.42) (782.57 ± 212.32) and (368.10 ± 112.42), Cho / Cr and Cho are respectively (3.22 ± 1.62) and (1.79 ± 1.22), and the differences were statistically significant (P <0.01). Its NAA / Cr (0.92 ± 0.41) and (1.28 ± 0.61) was not statistically significant (P> 0.05). Conclusions: (1) DWI and 1 H-MRS effective diagnosis and differential diagnosis of intracranial cystic lesions MRI technology. (2) DWI and 1 H-MRS effectively identify necrotic or cystic tumor and brain abscess. (3) DWI effectively identify epidermoid cyst, arachnoid cyst. (4) 1 H-MRS difficult to identify to identify epidermoid cyst and arachnoid cyst.
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