^1HMR波谱联合扩散张量成像在海洛因中毒性脑损伤中的价值

^1HMR spectrosocopy and diffusion tensor technology in heroin-induced brain damage

目的探讨^1HMR波谱（^1HMRS）及扩散张量成像（DTT）联合应用在显示海洛因中毒性脑损伤中的价值。方法对7例海洛因依赖患者（吸毒组）及8名健康志愿者（对照组）行MR、^1HMRS及DTT检查。^1HMRS感兴趣区选在前额叶，分别测量灰质及白质中乙酰天冬氨酸（NAA）／肌酸（Cr）、胆碱（Cho）／Cr及Cho／NAA的比值。DTT感兴趣区选在胼胝体膝部（GCC）、胼胝体压部（SCC）、内囊前肢（AIC）、内囊后肢（PIC）、外囊（EC）及前额叶白质（WMPFL），并分别测量其各向异性分数（FA）及表观扩散系数（ADC）。2组间比较采用独立样本t检验。结果所有受检者MRI均未见明显异常。^1HMRS吸毒组前额叶灰质及白质中NAA／Cr比值降低，分别为1．40±0．16、1．72±0．41，对照组分别为1．57±0．09、2．08±0．21，2组差异有统计学意义（t值分别为2．183、2．190，P值均〈0．05）。DTT吸毒组GCC、SCC及AIC的FA值降低，分别为0．70±0．04、0．76±0．41、0．55±0．03，对照组分别为0．76±0．03、0．82±0．03、0．64±0．03，2组差异有统计学意义（t值分别为3．830、3．713、5．555，P值均〈0．05）；吸毒组SCC、PIC及EC的ADC值升高，分别为（8．18±0．48）×10^-4、（7．54±0．22）×10^-4、（7．72±0．30）×10^-4mm^2／s，对照组分别为（7．50±0．26）×10^-4、（7．15±0．20）×10^-4、（7．19±0．39）×1014mm^2／s，2组差异有统计学意义（t值分别为3．477、3．507、2．895，P值均〈0．05）。结论联合。HMRS及DTT技术可较全面地显示海洛因中毒性脑损伤早期脑灰白质改变情况。

Objective To study the values of ^1HMRS and DTT technology for detecting brain damage in heroin-dependent patients. Methods The routine MRI, ^1HMRS and DTT were performed in 7 heroin abusers and 8 healthy volunteers without the history of drug abuse. The regions of interest （ROI） were selected in the gray matter and white matter of prefrontal lobe in ^1HMRS exam, and the ratio of NAA/ Cr,Cho/Cr and Cho/NAA were measured respectively. For the DTT, six ROIs were selected, and the values of fractional anisotropy （FA） and ADC were calculated respectively. The independent samples t test was used for the statistics. Results No abnormality was found in the routine MRI. The ratio of NAA/Cr decreased in the prefrontal lobe, the values were 1.40 ±0. 16 in gray matter and 1.72 ±0.41 in white matter of the drug group, 1.57 ± 0.09 and 2. 08 ± 0. 21 in the control group on ^1HMRS examiation. The difference between the two groups had statistical significance （t =2. 183, 2. 190, P 〈0.05）. On DTT examination, the values of FA decreased in GCC, SCC and AIC, each was 0. 70 ±0. 04, 0. 76 ±0. 41, 0. 55 ±0. 03 in drug group, and 0. 76 ± 0.03, 0. 82 ± 0.03, 0. 64 ± 0. 03 in control group. The difference between the two groups had statistical significance （t =3. 830, 3. 713, 5. 555, P 〈 0. 05）. The values of ADC increased in SCC, PIC and EC in drug group, each was （8. 18 ±0.48） × 10^-4, （7.54 ±0.22） × 10^-4, （7.72 ±0.30） × 10^-4,and （7.50±0.26） × 10^-4, （7. 15 ±0.20） × 10^-4,（7. 19 ±0.39） × 10^-4 mm^2/s in control group respectively. The difference between the two groups had statistical significance （ t = 3. 477, 3. 507, 2. 895, P 〈 0. 05 ）. Conclusion The early abnormalities of the brain in heroin-induced patients can be found combining ^1HMRS and DTT.