单纯性高热惊厥患儿小脑磁共振波谱成像初探

Preliminary study of cerebellar magnetic resonance spectroscopy on simple febrile convulsion in children

目的:应用磁共振波谱技术(MRS)探讨单纯性高热惊厥(SFC)患儿的小脑代谢物变化。方法:选取9例确诊为SFC的患儿(实验组)和7例年龄相匹配的健康儿童(对照组),采用化学位移成像采集小脑的MRS数据,测量实验组及对照组的代谢物比值NAA/Cr、NAA/Cr_2、NAA/Cho、Cho/Cr、Cho/Cr_2,采用Mann-Whitney U检验比较两组间MRS代谢参数之间的差异;并统计两组间Lac峰出现的例数,应用Fisher确切概率法比较有无差异。结果:实验组小脑的NAA/Cr低于对照组(0.91±0.12比1.03±0.07,P=0.023),实验组小脑的NAA/Cr_2、NAA/Cho、Cho/Cr、Cho/Cr_2与对照组间差异无统计学意义(均P>0.05);实验组9例患儿中5例小脑区域发现明显的Lac峰,对照组7例儿童小脑均未发现Lac峰,差别具有统计学意义(P=0.034)。结论:应用MRS技术可敏感的探测SFC患儿脑组织代谢物的变化,有助于从生化角度评价SFC导致的脑损害。

Objective： To explore changes in metabolite levels of cerebellum for children with simple febrile convulsion （SFC） by magnetic resonance spectroscopy（MRS）. Methods： Nine children diagnosed SFC and seven age-matched healthy chil- dren were enrolled. Multi-voxel chemical shift imaging was performed. The metabolite ratios of cerebellum involving NAA/Cr, NAA/Cr2, Cho/Cr, Cho/Cr2 and NAA/Cho were estimated. The Mann-Whitney U test was performed to compare the differences between the two groups. Lac p, eak was recorded and analysed between two groups and Fisher＇s exact test was performed to compare the differences. Results： The ratio of NAA/Cr in cerebellum with SFC was found to be decreased compared to normal control subjects （0.91±0.12 vs 1.03±0.07, P=0.023）. There was no statistical difference for the ratios of NAA/Cr2, Cho/Cr2, NAA/Cho （P〉0.05）. Lac peaks were detected in the cerebellum of five cases with SFC and no Lac peak was detected in the control group. The difference showed statistical significance （P=0.034）. Conclusion： MRS is a useful tool for evaluating major changes in metabolite levels of brain and may contribute to evaluate the damage caused by SFC from the biochemical aspect.