磁共振波谱、弥散张量成像检查诊断脊髓小脑性共济失调的价值

Diagnosis value of functional neuroimaging in spinocerebellar ataxia

目的探讨磁共振波谱(MRS)、弥散张量成像(DTI)检查诊断进行性遗传性脊髓小脑性共济失调(SCA)的价值。方法选择SCA患者30例(SCA组),同期选择30例健康体检者作为对照组,分别进行小脑蚓部及小脑半球MRS、DTI检查,并对SCA组进行突变基因筛查。结果 SCA组中有20例筛查到突变基因。MRS检查发现,与对照组比较,SCA组小脑蚓部NAA/Cr、Cho/Cr减低(P<0.05或<0.01),小脑半球NAA/Cr轻度减低(P<0.05),小脑半球Cho/Cr无明显变化。DTI检查发现,SCA组小脑中脚及桥脑腹侧部分横向纤维显示不完整。结论MRS、DTI检查能在小脑萎缩发生之前观察到脑组织代谢产物降低及脑桥横向纤维显示不清,可为临床早期诊断提供帮助。

Objective To discuss the value of MRS and DTI in the diagnostic of spinocerebellar ataxia （SCA）. Methods 30 patients with SCA were performed brain routine MRI , single-voxel I H-MR spectroscopy（MRS） and diffu sion tensor imaging （DTI） in the cerebellar. Results 20 cases of SCA patients were screening the mutant gene. The NAA/Cr rates and Cho/Cr rates in the cerebellar vermis of the patients with SCA were decreased. The NAA/Cr rates in the bilateral cerebellar hemispheres were decreased in the SCA, and the Cho/Cr rates was normal in the cerebellar hemi spheres. The transverse pontine fibers showed incompletely on DTI colour FA image at the level of superior cerebellar pe duncle in the patients with SCA, Conclusions Various of MRS and DTI techniques may reflect the main pathologic find ings of SCA, the change of metabolites and transverse pontine fibers show incompletely may occur before the clinical diag nosis of cerebellar atrophy, and can provide clues as to the diagnosis of SCA.