磁共振波谱分析海马诊断首发抑郁症

目的观察磁共振波谱分析(MRS)所示双侧海马代谢物改变对于诊断首发抑郁症(DD)的意义。方法对44例首发DD患者(DD组)及20名正常人(对照组)测量双侧海马肌酸(Cr)、N-乙酰天门冬氨酸(NAA)、胆碱(Cho)和肌醇(MI)峰下面积,计算NAA/Cr、Cho/Cr及MI/Cr,分析组间各指标差异;采用Logistic回归建立预测模型,以ROC曲线计算相关代谢物改变,作为首发DD临床诊断指标,并基于约登指数得出诊断阈值。结果DD组右侧海马Cho、NAA/Cr、Cho/Cr值均低于对照组(P均<0.05),右侧海马NAA、Cho、NAA/Cr、Cho/Cr和预测模型诊断DD的敏感度分别为54.54%、50.00%、45.45%、63.63%和77.27%,特异度分别为90.00%、100%、100%、80.00%和80.00%。结论MRS可辅助诊断首发DD;海马区Cho及Cho/Cr下降可能是早期DD标志,Cho、NAA/Cr及Cho/Cr可作为诊断首发DD的指标。

Magnetic resonance spectroscopy in hippocampus for diagnosis of first-episode depression disorder

Objective To observe the value of hippocampal metabolite changes detected with magnetic resonance spectroscopy (MRS) for diagnosis of first-episode depression disorder (DD).Methods Creatine (Cr), N-acetylaspartate (NAA), choline (Cho) and inositol (MI) peak area in bilateral hippocampus were measured in 44 patients with first-episode DD (DD group) and 20 normal subjects (control group). The ratio of NAA/Cr, Cho/Cr and MI/Cr were calculated, and the indexes were compared between 2 groups. Then prediction model was established using Logistic regression, and the changes of related metabolites were calculated with ROC curve and taken as the clinical diagnostic indexes of first-episode DD, while the diagnosis threshold was given based on Youden index.Results Cho, NAA/Cr, Cho/Cr in right hippocampus of DD group were all significantly higher than those in control group (all P<0.05), the sensitivity of Cho, NAA/Cr, Cho/Cr in right hippocampus and prediction model for diagnosis of DD was 54.54%, 50.00%, 45.45%, 63.63% and 77.27%, the specificity was 90.00%, 100%, 100%, 80.00% and 80.00%, respectively.Conclusion MRS might assist diagnosis of first-episode DD.The decrease of Cho and Cho/Cr in hippocampus might be signs of DD, while Cho, NAA/Cr and Cho/Cr could be used as diagnostic markers.