常规MRI阴性HIV感染者无神经症状期脑~1H-MRS分析

Brain ~1H-MRS Analysis of Asymptomatic HIV Infected Patients with Normal MR Findings

目的探讨常规MRI阴性人类获得性免疫缺陷病毒(HIV)感染者无神经症状期脑氢质子磁共振波谱(1H-MRS)特点。资料与方法搜集无神经症状期HIV感染者28例,HIV阴性健康自愿者30名,行MRI平扫、点分辨波谱(PRESS)1H-MRS扫描。测定脑皮质、深部核团及白质区N-乙酰天门冬氨酸(NAA)、胆碱化合物(Cho)、肌酸(Cr)峰下面积;计算NAA/Cr、Cho/Cr、NAA/Cho、(NAA+Cho)/Cr及(Cho+Cr)/NAA值。结果无神经症状期HIV感染者脑皮质、深部核团及白质NAA/Cr值均降低,(Cho+Cr)/NAA值升高,Cho/Cr值无明显变化。额上回皮质NAA/Cr、NAA/Cho、(Cho+Cr)/NAA值,额上回白质NAA/Cr、(NAA+Cho)/Cr、(Cho+Cr)/NAA值,顶叶白质NAA/Cho、(Cho+Cr)/NAA值差异有统计学意义(P<0.05)。结论在HIV感染无神经症状期,常规MRS阴性时,1H-MRS可以检测到脑早期代谢异常。额上回皮质、尾状核头部、额上回、顶叶白质NAA/Cr、NAA/Cho、(Cho+Cr)/NAA值有明显变化。

Objective To determine the brain 1H-MRS characters of asymptomatic HIV-infected patients with normal MR findings. Materials and Methods 28 asymptomatic HIV-infected patients and 30 health volunteers performed brain MRI plain scan and 1H-MRS.The areas under the three peaks of NAA,Cr,Cho were measured at the white and gray matter. The ratios of NAA/Cr,Cho/Cr,NAA/Cho,（NAA＋Cho）/Cr and（Cho＋Cr）/NAA were calculated. Results In HIV-infected patients,NAA/Cr was decreased and （Cho＋Cr）/NAA was increased at the white and gray matter. There were significant differences of NAA/Cr,NAA/Cho,（Cho＋Cr）/NAA at gyrus frontalis superior between HIV-infected patients and volunteers. NAA/Cr,（NAA＋Cho）/Cr,（Cho＋Cr）/NAA at the superfrontal white matter and NAA/Cho,（Cho＋Cr）/NAA at the parietal white matter had significant differences between HIV-infected patients and volunteers. Conclusion 1H-MRS is more sensitive in detecting CNS involvement in asymptomatic HIV-infected patients,therefore,be used for early detection of brain damage induced by HIV.