脊髓型颈椎病患者大脑中央前回磁共振波谱的初步研究

Proton Magnetic Resonance Spectroscopy of Primary Motor Cortex in Cervical Spondylotic Myelopathy:A Preliminary Study

目的采用~1H-MRS技术研究脊髓型颈椎病(CSM)患者与健康对照组大脑初级运动皮层内相关代谢物含量差异,并分析代谢物比值与改良日本骨科协会评估治疗(mJOA)评分之间的相关性。方法选择26例确诊为CSM及14例健康志愿者进行头颈部常规MRI及多体素~1H-MRS检查,分别测量双侧中央前回(手运动区)兴趣区的主要代谢产物乙酰天门冬氨酸(NAA)、胆碱复合物(Cho)、肌酸(Cr)。所有受试者均进行mJOA评分。结果与健康对照组相比,CSM组的NAA/Cr值显著降低(P<0.05),而两组间Cho/Cr值差异无统计学意义(P>0.05)。CSM组的mJOA评分较对照组减低,但与患者的NAA/Cr、Cho/Cr值无显著相关。结论~1H-MRS可以检测到CSM患者脑初级运动皮层内代谢物的变化,对CSM患者神经功能损伤评估、指导临床诊疗有一定的价值。

Objective To study the difference of metabolic characteristics in the brain among cervical spondylotic myelopathy( CSM) and healthy controls by proton magnetic resonance spectroscopy(~1 H-MRS),and to analyze correlation between ratios of metabolite concentration and m JOA score. Methods MRI and ~1 H-MRS were carried out in 26 patients with CSM and 14 healthy control subjects. The NAA,Cr and Cho peaks were measured in each volume of interest. All subjects received m JOA scores. Results The level of the NAA/Cr ratios in CSM patients was significantly lower than that of the normal controls. Although there was a trend towards decreased Cho/Cr in CSM patients,it did not reach statistical significance. The m JOA score of the CSM group was decreased,but there was no significantly correlated with NAA/Cr andCho/Cr value. Conclusion ~1 H-MRS can detect the changes of metabolites in the motor cortex of CSM patients,which is of certain value for the assessment of neurological damage and the guidance of clinical diagnosis and treatment of CSM patients.