脑梗死~1H磁共振波谱研究初探

目的 :初步探讨脑部1H磁共振波谱分析对脑梗死治疗和预后的价值。材料和方法 :22例脑梗死患者行32次常规MRI和1H -MRS检查。MRS检查采用PRESS序列 ,对病变区和对侧半球相应部位进行测量。主要观察的代谢物为NAA ,Cr,Cho和Lac。病灶NAA ,Cr和Cho的相对值以病侧和对侧各代谢物共振峰谱线下积分面积的比值来表示。病灶Lac的相对值则以病灶Lac和对侧Cr共振峰高度的比值来表示。结果 :超急性期脑梗死NAA下降 ,并出现Lac峰 ,而Cr和Cho无明显变化。随病情进展NAA进一步减少 ,以至消失 ;Lac峰仍持续存在 ,至慢性晚期逐渐消失 ;Cr和Cho也逐渐减少 ,但Cho减少的程度颇多变异。结论 :1H -MRS所提供的脑梗死区代谢变化对脑梗死救治时间窗口的预测可能有一定帮助。

~1H-MR Spectroscopy of Cerebral Infarction

Purpose:To investigate the value of 1H-MRS in therapy and prognosis of cerebral infarction.Materials and Methods:22 patients with cerebral infarction underwent 32 conventional MRI and 1H-MRS.A PRESS acquisition was used for 1H-MRS.Both the lesion region and the contralateral side were measured.The metabolites of NAA,Cr,Cho and Lac were analyzed.The signals from NAA,Cr,and Cho in the lesions were compared with those on the contralateral side as peak area ratios.Lac in the lesion was compared with Cr on the contralateral side as peak height ratios.Results:Decreased NAA,detection of Lac,no obvious changes of Cr and Cho were showed in hyperacute stage of cerebral infarction.As time progress,NAA continued to decrease of even disappear;Lac continued to present in acute and subacute stage,and gradually disappear in chronic stage;Cr and Cho also gradually decreased,but the decreased levels of Cho were varied.Conclusion:1H-MRS can provide information about metabolic changes that may be useful for prediction of therapeutic time window of cerebral infarction.