氢质子磁共振波谱对持续植物状态预后的评估价值

目的 研究持续植物状态（PVS）患者磁共振波谱分析（MRS）影像学特征,分析MRS对PVS预后判断能力.方法 对病例组（PVS患者28例）治疗前行MRS检查,测定丘脑、基底节NAA/Cr、Cho/Cr、NAA/Cho的比值,与对照组（健康体检者30例）对比差异,对所测结果与临床综合治疗后PVS总疗效评分进行统计学分析.结果 丘脑、基底节可视损伤区MRS表现与对照组间存在显著性差异（P＜0.01）,表观正常区MRS表现与对照组也存在统计学差异（P＜0.05）,且该差异性导致丘脑NAA/Cr、NAA/Cho比值以及基底节NAA/Cr比值与PVS总疗效评分分级之间呈正相关.结论 MRS在PVS预后中的作用具有非常好的价值和潜力,丘脑表观正常区及NAA/Cr比值可作为较好的感兴趣区及判断指标.

Evaluation of proton magnetic resonance spectroscopy in the prognostic assessment of patients with persistent vegetative state

Objective To explore whether proton magnetic resonance spectroscopy （MRS）,a newer radiographic technology,would be useful in the evaluation of the patients in persistent vegetative state.Methods 28 patients who were in the vegetative state before being treatment and 30 healthy volunteer both had proton MRS studies.NAA/Cr and Cho/Cr and NAA/Cho ratios were obtained for each patient in the dorsal thalamus and basal ganglia,and then statistical analysis was performed.Results There was significant difference between PVS groupand the control group of MRS in Thalamus,basal ganglia visible damage zone （P ＜ 0.05）.Also there was the same result in apparent normal zone（P ＜ 0.05）.Differences in NAA/Cr,NAA/Cho ratio of hypothalamic and NAA/Cr ratio of basal ganglia were positively correlated with PVS efficacy score grading.Conclusion For attempting to predict PVS prognosis,MRS has a very good value and potential.The apparent normal zone of hypothalamus and NAA/Cr ratio may be a good choice of VOI and evaluation index.