慢性高原病腰椎骨髓MR信号及波谱分析

Magnetic Resonance and Spectrum Signal Analysis on Lumbar Vertebra Marrow in Chronic High Altitude Disease

目的探讨藏族慢性高原病患者与高原藏族志愿者腰椎骨髓的磁共振信号强度和波谱特征及差异。方法按纳入标准选择慢性高原病患者20例和对照组50例进行腰椎MRI检查,选择L3椎体测定参数,磁共振T1-TFE序列测定信号强度;T2MAP序列测量T2时间;氢质子磁共振波谱（^1H-MRS）测量腰椎骨髓波谱信号,测得脂水比和脂含量,统计学分析探讨差异。结果两组年龄、身高无显著差异,体重、体重指数、血色素、氧饱和度存在显著差异。腰椎信号较低,部分慢性高原病患者的肝脏、脾脏、髂骨也呈极低的信号。测得的T2时间无显著差异,波谱为水高脂低的特征谱线,水的峰下面积P=0.036,脂峰宽度P=0.000,有显著性差异。其余参数均无显著性差异。结论慢性高原病患者体重指数偏高,腰椎信号低,波谱水浓度高系红髓增生所致,脂质成分出现差异。

Objective Explore magnetic resonance signal intensity and spectrum characters and differences between Tibetan people with chronic altitude disease and plateau Tibetan Volunteers. Methods 20 patients with chronic high altitude disease and 50 cases of the control group were selected for MRI examination of lumbar vertebra according to the inclusion criteria. Determination of parameters were selected in the L3 vertebral body. Testing the signal intensity of MR T1-TFE sequence,T2 time by T2MAP and lumbar myeloid spectroscopy signal by ^1H-MRS measurement. Lipid-water and fat content were calculated to evaluate statistical differences. Results There were significant differences between the two groups in body weight,body mass index,hemoglobin and oxygen saturation except age and height. Lumbar signal is low as well as liver,spleen,ilium in some patients with chronic high altitude disease. T2 time has no significant differences. Spectral analysis found that there is a high in water and low in fat. Water area under the peak（ P = 0. 036）,fat width（ P = 0. 000） showed a significant difference. On the contrary,the other parameters hardly presented significant difference. Conclusion Chronic high altitude patients have high body mass index,low lumbar spine signal,high spectral water concentration due to red marrow hyperplasia,and differences in lipid composition.