颈髓急性损伤后的磁共振波谱评价

目的:探讨颈髓急性损伤后磁共振波谱(1H-MRS)的诊断价值。方法:对19例急性颈髓损伤患者根据神经功能分为完全性损伤及不全性损伤两组,选取创区与创区头侧远端颈髓行1H-MRS,半定量分析氮-乙酰门冬氨酸(NAA)、胆碱(Cho)、肌酸(Cr)和乳酸(Lac)含量的比值。结果:颈髓完全性损伤组中NAA/Cho、NAA/Cr显著减低,Lac/Cho显著增高,其创区头侧远端Lac/Cho含量也增高(P<0.05);不完全损伤组中仅Lac/Cho含量增加,头侧远端乳酸含量亦增高(P<0.05)。颈髓损伤不同程度组间NAA/Cho、NAA/Cr有显著性差异(P<0.05)。结论:1H-MRS所测NAA/Cho、NAA/Cr从代谢水平反映颈髓损伤的不同程度,创区头侧远端Lac/Cho比值增高提示颈髓隐匿损伤的存在。

Evaluation of the spinal cord metabolic changes with 1H-MRS after acute spinal cord injury

Objective:To discuss the utility of 1 H-MRS for diagnosis the acute spinal cord injury(ASCI).Method:19patients of ASCI were performed by1.5T 1 H-MRS/MRI system on the injuried and cephalic spinal cord.The ratio values of NAA/Cr?NAA/Cho?Cho/Cr?Lac/Cr were calculated and analyzed by integration of their peaks.Result:The ratios of NAA/Cr and NAA/Cho were decreased,and Lac/Cr were increased in those complete SCI patients,also only the ratios of Lac/Cho were increased in those incomplete SCI patients,the Lac/Cho in cephalic spinal cord of both the two groups were increased.Compared complete CSI to incomplete CSI,the value was lower in NAA/Cho?NAA/Cr(P<0.05).Conclusion:1 H-MRS can quantitatively analyse the metabolic abnormalities and reflect the metabolized level of acute SCI.To combine MRI with 1 H-MRS can provide useful information for evaluation of acute SCI.