成人轻中型颅脑损伤挫裂伤区域的多体素1H-MRS研究

Multivoxel 1H-MRS for contusion and laceration area of mild-to-moderate traumatic brain injury with in adults

目的探讨多体素1H-MRS在成人轻中型TBI挫裂伤区域中的应用价值。方法选取28例诊断明确的TBI患者,多体素1H-MRS采集挫裂伤区域NAA、Cho、Cr等峰,并计算多种代谢物比值平均值。结果多体素1H-MRS示挫裂伤区域NAA/Cr、NAA/Cho及Cho/Cr平均值与正常对照组比较有显著性差异(P<0.01);轻、中型组间比较,NAA/Cr值有显著性差异(P<0.01),而2组的NAA/Cho和Cho/Cr值则无显著性差异(P>0.05)。结论多体素1H-MRS分析对轻中型TBI的早期诊断及伤情的评估有重要价值,损伤区NAA/Cr值的变化能客观地反映脑损伤的严重程度。

Objective To investigate the value of muhivoxel proton magnetic resonance spectroscopy （1H-MRS） in contusion and laceration area of mild-to-moderate traumatic brain injury （TBI） in adults. Methods Twenty-eight TBI patients definitely diagnosed were recruited in this study, including 16 moderate TBI whose Glasgow coma scores were in 9 - 12 and 12 mild TBI whose Glasgow coma scores were in 13 - 15. The spectrum for NAA, Cho, Cr and other metabolite peaks in contusion and laceration area were measured and NAA/Cr, NAA/Cho, Cho/Cr ratios were calculated for each voxel. Results In multivoxel 1H-MRS for the lesion areas, the ratios of NAA/Cr, NAA/Cho and Cho/Cr changed significantly compared with those of 16 norreal controls （P 〈0. 01 ）. The ratio of NAA/Cr in contusion and laceration area in those with moderate TBI was significantly lower than those with mild TBI （P 〈 0.01 ）, but the ratios of NAA/Cho and Cho/Cr showed no significant statistical difference between them （ P 〉 0. 05 ）. Conclusion Muhivoxel 1H-MRS may have an important clinical value in detecting and assessing early mild-to-moderate brain trauma. NAA/Cr ratio of the injured region can reflect the severity of cerebral injury.