紫绀型先天性心脏病脑代谢异常的磁共振质子波谱研究

~1H-MRS study of brain metabolic disorder in patients with cyanosed congenital heart disease

目的 用磁共振质子波谱 (1H MRS)方法观察紫绀型先天性心脏病的脑代谢异常。方法 应用场强为 2 .0T的磁共振成像系统分别对 2 5例紫绀型先天性心脏病 (CCHD)患儿及对照组儿童的脑组织进行MRI检查及1H MRS采集 ,并对结果进行统计学分析。结果 病例组儿童与对照组儿童相比 ,N 乙酰天门冬氨酸 (NAA)与总肌酸 (Cr)的比值明显降低 (P <0 .0 0 1) ,谷氨酸 谷氨酰胺复合物 [GLX α、GLX (β +γ) ]及乳酸 (Lac)分别与Cr相比 ,其比值均有明显增高 (P <0 .0 1) ,而含胆碱复合物 (Cho)与Cr的比值两组间差异无显著性意义 (P >0 .0 5 )。结论 磁共振质子波谱能无创性地观察到紫绀型先天性心脏病患儿脑代谢异常的部分产物 。

Objective To study the metabolic alteration in the brain of patients with cyanosed congenital heart disease (CCHD) by using 1H magnetic resonance spectroscopy ( 1H MRS) and discover the pathophysiology of chronic hypoxic brain, which will help to diagnose and treat this disease completely. Methods Twenty five patients with CCHD and 25 controls were performed PRESS 1H MRS and MRI, The areas under the resonance of metabolites were measured, the ratios of the other metabolites to Cr were calculated and compared. Results In patients with CCHD, the mean value of NAA/ Cr was significantly lower than that in controls ( P <0.001), Lac/Cr、GLX α and GLX (β+γ)/ Cr were significantly higher in patients than those in controls( P <0.01), the mean value of Cho/Cr had no differences between two groups( P >0.05). Conclusion 1H MRS can detect brain metabolic changes in patients with cyanosed congenital heart disease in vivo noninvasively and can detect the metabolism disorder of the energy and amino acid, so the pathophysiology of this disease can be understood.