急性脑梗死患者梗死区表观弥散系数与脑内代谢物质的相关性

目的 探讨急性脑梗死后梗死区表观弥散系数（ADC）和脑内代谢物质的变化及ADC值与脑内代谢物质的相关性.方法 连续纳入急性脑梗死患者32例,行头部MR平扫、磁共振弥散加权成像（DWI）检查,分析梗死灶中心区、周边区、外围正常区及梗死灶中心区对侧镜像区（以下简称镜像区）的ADC值;行1H-磁共振波谱（1H-MRS）检查,测定上述各区的N-乙酰天门冬氨酸（NAA）、胆碱、肌酸及乳酸的含量.并进行ADC值与NAA、胆碱、乳酸的相关性分析.结果 ①与镜像区比较,梗死灶中心区的ADC值降低最明显,其次是周围区,差异均有统计学意义,P〈0.01;外围正常区ADC值无明显变化.②与镜像区比较,梗死灶中心区的NAA含量降低、乳酸含鼍升高均为最明显;外围正常区的NAA和乳酸无明显变化;梗死周围区、外围正常区、镜像区的胆碱含量差异均无统计学意义,但均高于梗死中心区,且差异有统计学意义（P〈0.05,P〈0.01.③急性脑梗死后,脑组织的ADC值与NAA含量呈正相关（rs=0.196,P=0.027）,与乳酸旱负相关（rs=-0.381,P=0.000）,与胆碱无相关性（rs=0.088,P=0.326）.结论 急性脑梗死后梗死中心区和周围区的ADC值、NAA、胆碱和乳酸的含量出现变化;ADC值的变化与NAA、乳酸含量有一定的相关性.

Correlation between apparent diffusion coefficient and brain metabolites in infarct area of patients with acute cerebral infarction

Objective To investigate the changes of brain metabolites of apparent diffusion coeffi- cient （ADC） in infarct area after acute cerebral infarction and the correlation between the ADC values and brain metabolites. Methods Thirty-two consecutive patients with acute cerebral infaretion were enrolled in the study. They were all performed head MR scan, magnetic resonance diffusion weighted imaging （DWI）, ADC map and magnetic resonance spectroscopy（MRS）. The ADC values and the content of N- acetyl aspartate （NAA）, choline, creatine, and lactic acid were measured in the central and peripheral area of infarction, peripheral normal brain tissue, and the contralateral mirror image area of the central area of infarction（ mirror image area）. The correlation analyses between ADC values and NAA, choline, creatine, and lactic acid were performed. Results ①Compared with the contralateral mirror image area, the ADC value decreased significantly in the central area of infarction, and the ADC value decreased mildly in the peripheral area （ P 〈 0. 01 ）. The ADC values did not change significantly in the peripheral normal brain tissue. Compared with the contralateral mirror image area, the NAA content decreased significantly and the lactic acid content increased significantly in the central area of infarction. The NAA content decreased mildly and the lactic acid content increased mildly in the peripheral area. There were no significant changes in the NAA and lactic acid in the peripheral normal brain tissue. There were no significant differences in the choline content in the peripheral area of infarction, peripheral normal area and mirror image area, but they were all higher than that in the central area of infarction, and the differences were significant （ P 〈0. 05, P 〈0. 01 ）. ③After acute cerebral infarction, the ADC value of brain tissue was positively correlated with the NAA content （r1 = 0. 196, P = 0. 027 ）, negatively correlated with the lactic acid content （ r = - 0. 381, P = 0. 000）, and was not correlated with the choline content （ r = 0. 088, P = 0. 326）. Conclusion The ADC value, NAA, choline and choline content changed in the central area of infarction and peripheral area after acute cerebral infarction. The changes of ADC values has a certain correlation with the NAA and lactic acid content.