皮质下动脉硬化性脑病的1H—MRS初步研究

Preliminary study of proton magnetic resonance spectroscopy （1H-MRS） in the subcortical arteriosclerotic encephalopathy

目的应用2D多体素1 H质子磁共振波谱成像(1 H-MRS)检查皮质下动脉硬化性脑病(BD)患者,分析其代谢产物特点及变化规律。方法对经临床诊断的20例BD患者和20名健康老年人行常规MRI和二维1 H-MRS检查,测量BD组常规MRI表现阳性病灶区、BD组表现正常脑白质区及对照组正常脑白质3组NAA/Cr、Cho/Cr值,并进行统计学分析;观察Lac峰的变化情况。结果 BD病灶区NAA/Cr值、Cho/Cr值降低,与对照组脑白质差异均有统计学意义(P<0.05);BD正常脑白质区NAA/Cr值与正常对照组相比有所降低,且差异有统计学意义(P<0.05),BD正常脑白质区Cho/Cr值较对照组脑白质相比差异没有统计学意义(P>0.05);BD病灶区全部出现Lac峰,BD正常脑白质区出现Lac峰12例。结论 1 H-MRS检查能够反映BD代谢特点及变化规律;1 H-MRS中的NAA/Cr可以显示常规MRI检查表现正常的脑白质微代谢改变。

Objective To analyze the metabolic characteristics and change rules in the lesions of subcortical arteriosclerotic encephalopathy （SAE/BD） with 2D multivoxel proton magnetic resonance spectroscopy （1 H-MRS）. Methods Routine MRI and 2D 1 H-MRS were performed in 20 cases with BD and 20 healthy elderly as a control group. NAA/Cr and Cho/Cr were calculated and analyzed statistically in the lesions of BD, normal - white matter areas of BD and normal white matter areas of the control group, and the change of Lac peak was analyzed. Results NAA/Cr and Cho/Cr decreased in BD lesions and there was a significant difference between BD and the control group （ P 〈0.05）. NAA/Cr decreased in normal white matter of BD compared with the control group and there was a significant difference between the normal white matters of BD and the control group （ P 〈0.05）. But there was no significant difference of Cho/Cr between the normal white matters of BD and the control group （ P 〉0.05）. Lac peak appeared in all lesions of BD and 12 cases of normal white matter of BD. Conclusion 2D 1H-MRS could reflect the metabolic characteristics and change rules of BD; NAA/Cr of 2D 1 H-MRS can display microscopical metabolic changes of white matter, which are normal in conventional MRI.