氢质子磁共振波谱对创伤性脑损伤的分析

目的探讨氢质子磁共振波谱(1Hmagneticresonancespectroscopy1HMRS)分析对创伤性脑损伤(traumaticbraininjuryTBI)受伤程度、预后预测的临床价值。方法对25例TBI患者和10例正常志愿者进行1HMRS检查,观察患者与正常对照组及患者患侧与正常侧间N-乙酰天门冬氨酸(NAA)、胆碱(Cho)肌酸(Cr)、乳酸(Lac)及NAA/Cr、NAA/Cho、Cho/Cr值的变化,分析这些指标与格拉斯哥昏迷评分(GCS)及格拉斯哥预后评分(GOS)的相关性;结果TBI患者较正常对照组及其患者患侧脑白质较对侧同一位置常规MRI检查表现正常脑白质(nomal-appearingwhitematterNAWM)的NAA/Cho、NAA/Cr值下降更明显,而Cho/Cr值上升更明显;出现Lac水平上升患者的GCS为重度,其预后不良,NAA/Cr、NAA/Cho、Cho/Cr值变化与TBI患者GCS、GOS存在相关性;结论1HMRS对脑外伤的程度及预后预测有重要价值。

Analyses of traumatic brain injury using 1H MRS

Objective To evaluate clinical application of proton magnetic resonance spectroscopy (1H MRS) in the assessment of traumatic brain injury(TBI) and anticipation of the prognosis.Methods 25 patients with TBI and 10 volunteers were studied with 1H MRS. The MRS values including N- acetylasparate(NAA), Choline(Cho), Creatine(Cr), Lactate(Lac), NAA/Cr, NAA/Cho, and Cho/Cr of the study group and control group, as well as the values obtained at the injured side of the brain and the side untouched, were noted and comparatively studied with Glasgow Coma Scale(GCS) and Glasgow Outcome Scale(GOS).Result Compared with the control group, NAA/Cho, NAA/Cr in study group apparently decreased; while Cho/Cr remarkably increased. The same difference was revealed between involved region of the brain and the homologous location in the contra- lateral normal- appearing white matter(NAWM) hemisphere. Elevated level of Lac indicated severe injury and poor outcome. MRS values were significantly correlated with GCS scores and GOS scores.Conclusion 1H MRS plays an important role in the in the assessment of traumatic brain injury and anticipation of the clinical outcome.