多体素氢质子磁共振波谱成像(~1H-MRS)在急性脑梗死中的应用研究

目的探讨多体素氢质子磁共振波谱分析(~1H-MRS)在超急性与急性脑梗死中的应用价值及各代谢物浓度变化的规律和临床意义。方法选取23例超急性脑梗死与17例急性脑梗死患者为研究对象,行常规磁共振(MRI)及~1H-MRS扫描,分别比较病灶中心区、病灶边缘区、病灶周围正常区与对侧镜像区之间NAA、Cr、Cho等代谢物浓度的差异。结果①超急性期病灶中心区、病灶边缘区及病灶周围正常区NAA、Cr、Cho明显低于对侧镜像区(P0.05),病灶中心区、病灶边缘区Lac较对侧镜像区升高(P0.05)。②急性期病灶中心区、病灶边缘区及病灶周围正常区NAA、Cr明显低于对侧镜像区(P0.05),病灶中心区、病灶边缘区Cho明显低于对侧镜像区(P0.05),病灶中心区、病灶边缘区Lac较对侧镜像区升高(P0.05)。超急性期与急性期脑梗死患者各区代谢物比较未见明显差异。结论多体素~1H-MRS可以直接、准确、全面地检测脑梗死病灶侧及对侧镜像脑组织的代谢变化信息,不仅利于脑梗死后病理生理变化的研究,亦可对脑梗死临床治疗效果的客观评价提供依据。

The Application of Magnetic Resonance Spectroscopic Imaging in Acute Cerebral Infarction

Objective To investigate the application value of multivoxel proton magnetic resonance spectroscopy (1H-MRS) and variation of metabolite concentrations and its clinical significance in hyperacute and acute cerebral infarction.Methods 23 cases of hyperacute cerebral infarction and 19 cases of acute cerebral infarction were selected for the study,underwent conventional magnetic resonance (MRI) and 1H-MRS scans Then to compare the concentrations of Cr,Cho,NAA and other metabolites in the infraction center,the border region,the normal region around the lesion and the contralateral area.Results ①In the hyperacute cerebral infarction,the concentrations of Cr,Cho,NAA in the infraction center,the border region,the normal region around the lesion was significantly lower than the contralateral area (P＜0.05),Lac increase compared with the contralateral area.②In the acute cerebral infarction,the concentrations of Cr,NAA in the infraction center,the border region,the normal region around the lesion was significantly lower than the contralateral area (P＜0.05),the concentrations of Cho in the infraction center and the border region was significantly lower than in the contralateral area (P＜0.05),Lac increase compared with the contralateral area.There was no significantly different in the regional metabolites between the hyperacute cerebral infarction and the acute cerebral infarction.Conclusion Multivoxel 1H-MRS can directly,accurately and comprehensively display the metabolic changes of brain tissue in cerebral infarction side and contralateral area,it not only conducive to the study of the pathophysiological changes after cerebral infarction,but also to provide the evidence for clinical treatment of cerebral infarction.