运用磁共振波谱及弥散张量成像分析研究代谢综合征病程与脑代谢的相关性

Magnetic resonance spectroscopy and diffusion tensor imaging study of correlation of course and cerebral metabolism with metabolic syndrome

目的应用头颅磁共振波谱(MRS)和弥散张量成像(DTI)检测代谢综合征(MS)患者,了解氮-乙酰天门冬氨酸/肌酸(NAA/Cr)、乙酰胆碱/肌酸(Cho/Cr)、氮-乙酰天门冬氨酸/乙酰胆碱(NAA/Cho)、部分各向异性值(FA值)与MS病程的相关性。方法本研究分为病例组(MS患者15例)及对照组(健康体检者17例),检查一般项目(身高、体重、血压、血糖、血脂、神经功能相关量表评分),行头颅MRI、MRS及DTI检查,测定左侧扣带回后部、背侧丘脑、侧脑室后角NAA/Cr、Cho/Cr、NAA/Cho的比值和内囊后肢、放射冠区FA值,分析测定项目与MS病程的相关性。结果 (1)NAA/Cr与高血压、糖尿病、高脂血症等的年限有关(P<0.05)。(2)NAA/Cho与糖尿病、高脂血症及肥胖年限有关(P<0.05)。(3)FA值与高血压年限有关(P<0.05)。结论 MS患者脑细胞代谢功能、神经纤维微结构损害严重程度与MS的病程相关。

Objective To evaluate the correlation of course of metabolic syndrome（MS） with NAA/Cr, Cho/Cr, NAA/Cho and the FA values, using Magnetic Resonance Spectroscopy（MRS） and diffusion tensor imaging （DTI） to detect the metabolic changes in the encephalon in participants and the FA values in the brain with MS. Methods 32 participants were categorized into two groups, MS group（15 participants）and control group（1 7 participants）. We measured their body height, weight, blood pressure, blood glucose, blood lipid and nerves function rating scales, then examined their brain using magnetic resonance imaging （MRD, MRS and DTI, then analysed the correlation of course of MS with the mctabolite ratios of NAA/Cr, Cho/Cr, and NAA/Cho which were measured in the posterior cingnlate gyms, dorsal thalamus, and posterior part of lateral ventricle, and the FA values which were measured in the posterior limb of internal capsule （PLIC） and corona radiate area（CRA） were measured. Results （1）The ratio of NAA/Cr was associated with the course of hypertension, diabetes mellitus and hyperlipidernia （P〈 0.05）. （2）The ratio of NAA/Cho was associated with the course of diabetes mellitus, hyperlipidcmia and obesity （P〈0.05）. （3）The FA values was associated with age （P〈0.05）. Conclusion The impairment of brain cell metabolism and the nerve fibres structure in the brain of MS patients is related to the course of MS.