脑出血后脑水肿的磁共振波谱成像及相关因素的分析

Magnetic resonance spectroscopy study on the edema post cerebral hemorrhage and correlating factors

目的观察脑出血后迟发反常性脑水肿的磁共振波谱特点,并对其发生相关因素进行分析。方法对12例脑出血后第7天及14天脑水肿患者分别进行磁共振波谱成像(MRS)检查,观察血肿周围迟发水肿组织的MRS谱线特点,与脑出血后一周水肿的谱线的进行对照研究,定量分析相关代谢物的峰值的变化。结果9例患者获得满意谱线,血肿周围的14d水肿区NAA/Cr较7d血肿周围水肿区域明显降低(15.7%±9.2%)(P<0.01)。在第14天谱线中,7例检测出的乳酸峰,8例患者检测出甘露醇峰。结论脑出血水肿区MRS的NAA/Cr降低及乳酸峰出现,说明水肿区神经元的受损及缺血,迟发反常水肿区的甘露醇峰的存在,对迟发反常水肿起到重要作用,提示局部的血-脑脊液屏障的破坏。

Objective To observe the MR spectroscopy（MRS） characteristic of the delayed edema post cerebral hemorrhage and analysis of correlation factors. Methods Twelve cases of edema post cerebral hemorrhage after 7 and 14 days were performed with MRS study around the edema area and 7 days＇edema were examined as control group. Quantitative analysis NAA change and lactic acid peak and mannitol peak. Results 9 patients obtain satisfaction MRS,Compared with the 7 days＇MRS, the NAA/Cr deceased （ 15.7% ±9.2% ） （ P 〈0.01 ） in the delayed edema area, The lactic acid peaks were observed in 7 cases and the mannitel peak in 8 cases. Conclusion The NAA/Cr reduced and the lactic acid peak appeared in the delayed edema area may support neuron＇s damage and ischemia,And marmitol peak＇s existence, had played an important role to the delayed edema,prompted the destruction of the partial blood brain barrier.