多发性硬化的磁共振波谱研究

Study of 1^H magnetic resonance spectroscopy in multiple sclerosis

目的研究多发性硬化(MS)患者脑内病灶、表现正常脑白质(NAWM)及正常志愿者脑白质的代谢差异,并探讨代谢物浓度比值与临床残疾程度的相关性。方法对32例MS患者和25例正常志愿者进行MRI和质子磁共振波谱(1H MRS)检查,测量各感兴趣区的代谢产物氮-乙酰天冬氨酸(NAA)、肌酸(Cr)及胆碱(Cho)的浓度比率,并分析NAA/Cr及NAA/Cho与扩展残疾状态量表(EDSS)的相关性。结果MS患者的病灶内NAA/Cr及NAA/Cho显著低于NAWM(P<0.001),NAWM的NAA/Cr及NAA/Cho亦显著低于正常对照组(P<0.001)。MS患者病灶和NAWM的NAA/Cr及NAA/Cho与EDSS均无显著相关性。结论1H MRS能检测出MS患者脑部病灶及NAWM的代谢异常,为常规MRI提供补充信息。

Objective To study the difference of metabolic characteristics among lesions, normal-appearing white matter （NAWM） in multiple sclerosis （MS） and white matter in normal volunteers, and to investigate correlation between ratios of metabolite concentration and clinical disability. Methods MRI and ^1H magnetic resonance spectroscopy （^1H MRS） were performed in 32 MS patients and 25 healthy volunteers. The ratios of N-acetylaspartate （NAA）, creatine （Cr） and choline （Cho） peaks were measured in each volume of interest, and the correlation of expanded disability status scale （EDSS） with NAA/Cr and NAA/Cho were analyzed. Results NAA/Cr and NAA/Cho of lesions were significantly lower than those of NAWM in MS patients （P〈0. 001）. NAA/Cr and NAA/Cho of NAWM in MS were also significantly lower than those of normal white matter in control subjects （P〈0. 001）. No significant correlation was found between EDSS and NAA/Cr or NAA/Cho in both MS lesions and NAWM. Conclusion ^1H MRS can detect metabolic abnormalities in brain lesions and NAWM from MS patients and provide complementary information for conventional MRI.