质子磁共振波谱分析与脑梗塞预后的相关性研究

Study on the correlation between the proton magnetic resonance spectroscopy and the outcome of cerebral infarct

【目的】探讨质子磁共振波谱（^1H—MRS）对脑梗塞预后的预测价值。【方法】选择脑梗塞患者49例作为研究对象。依据发病至磁共振成像（MRI）检查时间，分为：超急性期（≤6h）15例，急性期（7—72h）18例，亚急性期（4～14d）16例。MRI检查使用GEsignlaHighspeed MR／i1．5T超导MRI仪和probe2000多体素^1H—MRS软件包。获取的资料为梗塞区及其镜像区的氮-乙酰门冬氨酸（NAA）和乳酸（Lac）的检测值。脑梗塞患者3个月时的临床预后评分，使用改良爱丁堡一斯堪的那维亚卒中量表（ESSS）和Bathel指数（BI）评定。统计分析方法使用直线相关分析。【结果】在超急性期，Lac与ESSS和BI显著相关（P〈0．01）；NAA’与ESSS和BI无直线相关关系（P〉0．05）。在急性期和亚急性期，NAA’、Lac均与ESSS和BI显著相关（P〈0．01）。【结论】脑梗塞的MRS分析对脑梗塞预后有预测价值。

[Objective] To study the predictive value of proton magnetic resonance spectroscopy （MRS） in cerebral infarct outcome. [Methods] 49 patients with recent cerebral infarction were enrolled the study, including： 15 patients superacutel （ ≤6 h）, 18 acutel （7 - 72 h） and 16 subacutel （4 - 14 d）. MRS were obtained on a GE sigma highspeed MR/i 1.5T superconductive MRI system and Probe 2000 muhi-voxel software package. The outcomes were measured by ESSS and Barthel Index （BI） three months after infarction. Statistical analysis using linear regression. [Results] In superacute stage, the content of lactate （Lac） was significently correlated to ESSS and BI（P 〈 0.01）, but nor NAA（P 〉 0.05）. In acute and subacute stage, N-acetylasparate＇ （NAA＇）, Lac were strongly correlated to ESSS and BI（P 〈 0.01）. [ Conclusions] The MRS can be used as an important method to predict the clinical outcome in cerebral infarct patients.