小儿正常小脑半球组织^1H-MRS研究

~1H-MRS Study of Normal Children＇s Cerebellum Hemisphere

目的:测定和计算0～7岁小儿正常小脑半球组织代谢物比值,并观察各比值随年龄变化规律。方法:应用多体素2D1H-MRS点分辨波谱(PRESS)序列测定70例0～7岁小儿正常小脑半球组织的双侧灰质及白质区代谢物浓度,按年龄分为0-1岁,1-2岁,2-3岁,3-5岁,5-7岁五组,计算和分析NAA/Cr、Cho/Cr、NAA/Cho的比值。结果:正常小脑灰质区在各年龄组间NAA/Cho(P=0.0143)和NAA/Cr(P=0.0050);白质区的NAA/Cho和NAA/Cr均P<0.001;灰质和白质区的Cho/Cr(P=0.1195,P>0.05);灰质和白质区NAA/Cho值与年龄呈正相关(P<0.001,P<0.0001);NAA/Cr值与年龄呈正相关(P=0.0004,P<0.0001);灰质区Cho/Cr与年龄呈负相关(P=0.038),白质区与年龄呈负相关(P=0.568>0.05)。结论:0～7岁小儿正常小脑半球灰、白质的代谢物比值在不同年龄组会不同,灰质和白质区NAA/Cho、NAA/Cr值随年龄增长逐渐升高,而灰质区Cho/Cr值逐渐减小,白质区无明显变化,临床上应用MRS要考虑其年龄和部位的因素。

Purpose： To qualify the metabolite ratios in normal cerebellum,and to discover the changes of it with age in the range from newborn to 7 years old.Methods： Seventy healthy subjects aged from newborn to 7 years old were examined by multi-voxel proton MR spectroscopy with PRESS sequence.The subjects were divided into five groups.The age of these groups was 0-1,1-2,2-3,3-5 and 5-7years,respectively.The NAA to Cr,Cho to Cr,NAA to Cho ratios were determined in selected bilateral cerebellum gray and white matter regions.Results： Both NAA to Cho and NAA to Cr ratios in both regions were shown with statistical differences among groups（P〈0.001）,and they were increased significantly with age（P〈0.001,P〈0.0001）.The Cho to Cr ratio was shown with no significant difference between gray and white matter regions（P =0.1195,P〉0.05）,which was with negative correlation with age in gray matter regions（P =0.038）.Conclusion： The metabolic concentration of cerebellum gray and white matter region was shown with significant differences in children aged from newborn to 7 years old.The NAA to Cho and NAA to Cr ratio in both regions were gradually increased with age,while Cho to Cr ratio was decreased in gray matter region.Therefore,when using MRS for diagnosis,the age and the msasured region of the patient should be considered.