多体素氢质子波谱对脑脓肿的诊断价值

Role of ^1H MR spectroscopy in diagnosis of brain abscesses

目的探讨磁共振氢质子波谱(1HMRS)技术对脑脓肿的诊断价值。方法对9例脑脓肿病人行常规MRI和1HMRS扫描。完成扫描后用随机分析软件包Functool2进行分析,获得脓液和脓肿壁的波谱图。结果9例病灶中8例检测到氨基酸(AA)峰,1例没有AA峰。另有2例脓液培养见厌氧菌生长的脓肿的波谱图中可见乙酸(Ac)峰和琥珀酸(Suc)峰。9例脓肿壁与对侧正常脑组织比较:Cho和NAA低于对侧并有显著性差异,Cho/NAA无显著性差异。结论1HMRS不但可提高细菌性脑脓肿的诊断准确率,而且还可根据Ac峰和Suc峰的有无提示是否厌氧菌感染,为临床治疗提供非常有价值的信息。

Objective To investigate the value of ^1H-MRS in the diagnosis of brain abscesses. Methods Conventional MR imaging and ^1H-MRS data were obtained from 9 patients with brain abscess. Metabolite patterns of pus and wall of abscess were retrospectively analyzed by using Functool 2 software. Results AAs were observed in 8 of 9 patients. Ac and Suc were observed in 2 of 9 patients in which pus culture were positive for obligate aerobes. On ^1H-MRS, Cho and NAA of abscess wall were significantly lower than that of normal control tissues （P〈0.01）, but Cho/NAA was not different significantly than that of normal control tissues （P〈0.05）. Conclusion ^1H-MRS can not only improve the accuracy of diagnosis, but also differentiate anaerobic from aerobic or sterile brain abscess on the basis of metabolite patterns observed at ^1H-MRS. It provides valuable information for appropriate patient management.