临床孤立综合征磁共振波谱的临床应用

目的探讨氢质子磁共振波谱(1H-MRS)技术在临床孤立综合征(CIS)中的临床应用价值。方法对6例CIS患者和5名健康自愿者进行3.0TMRI和1H-MRS检查,测量CIS病灶组、病灶邻近或对侧表现正常脑白质组(NAWM组)及自愿者正常脑白质组(对照组)主要代谢产物NAA、Cr、Cho、mI、Lac峰值,及NAA/Cr、NAA/Cho、Cho/Cr、mI/Cr的比值。结果 CIS病灶组、NAWM组NAA、Cr、Cho、mI峰下降,Lac峰升高,Lip峰变化不明显。病灶组、NAWM组NAA/Cr(分别为1.50±0.17、1.67±0.15)明显低于对照组(1.82±0.08,P<0.01);病灶组NAA/Cho(1.40±0.28)亦显著低于NAWM组(1.79±0.16)及对照组(2.10±0.25,P<0.001);病灶组的Cho/Cr(1.09±0.14)显著高于NAWM组(0.93±0.02)及对照组(0.83±0.11,P<0.001);病灶组和NAWM组的mI/Cr则与对照组无差异。结论 1H-MRS可反映CIS病灶的代谢异常、NAWM的早期生化代谢改变,对CIS患者神经功能损伤、疗效评价及预后判断有重要价值。

Clinical application of magnetic resonance spectroscopy in clinically isolated syndrome

Objective To evaluate the clinical value of proton magnetic resonance spectroscopy（1H-MRS） in clinically isolated syndrome（CIS）.Methods MRI and 1H-MRS were performed in 6 patients with CIS and 5 healthy volunteers.NAA,Cr,Cho,and Lac peaks and the ratio of NAA/Cr,NAA/Cho and Cho/Cr were measured in the lesions,NAWM,and normal control group.Results Compared with normal control group,decreased NAA,Cr,Cho,mI peaks were demonstrated among lesions and NAWM in CIS,and increased Lac peaks were demonstrated among them,and Lip peaks were not changed.The ratios of NAA/Cr in lesions and NAWM（respectively：1.50±0.17,1.67±0.15） from CIS patients were significantly decreased than that of control group（1.82±0.08,P〈0.01）.The ratio of NAA/Cho in lesions（1.40±0.28） was also significantly decreased than that of both NAWM（1.79±0.16） and control group（2.10±0.25,P〈0.001）;Cho/Cr in lesions（1.09±0.14） was significantly increased than that in NAWM（0.93±0.02） and that in the control group（0.83±0.11,P〈0.001）.mI/Cr in both lesions and NAWM was not more significant than that in control group.Conclusion 1H-MRS can reflect the metabolic abnormalities within the lesions and can detect the early biochemical changes in NAWM from CIS patients.1H-MRS has an important value in neurologic impairment,evaluation of therapeutic efficacy and prognosis.