脑多发性硬化1H磁共振质子波谱分析应用研究

目的探讨1H磁共振波谱（1HMRS）技术在脑多发性硬化（multiple sclerosis,MS）的诊断价值。方法选择29例经临床确诊的MS患者进行MR及1H MRS检查,并与同期相同年龄组MRI显示正常者进行对照研究,计算1H-MRS代谢产物N-乙酰天门冬氨酸（NAA）、肌酸（Cr）、胆碱复合物（Cho）及乳酸（LAC）的峰下面积,并对NAA/（Cr＋Cho）、Cho/Cr及LAC/Cr等各参数进行对比研究。结果MS组NAA/（Cr＋Cho）、Cho/Cr及LAC/Cr值分别为0.56、1.49及3.35,对照组分别为0.78、1.19及0.23。MS病人NAA/（Cr＋Cho）值下降,Cho/Cr、LAC/Cr值升高,统计学上差异有显着性意义（t值分别为4.76、2.36及4.11,p〈0.05）。结论1H MRS有很高的特异性,可以为MS早期诊断提供可靠的诊断信息,对指导临床治疗和判断预后有重要意义。

1H Magentic Resonance Spectroscopy in the Diagnoisis of Multiple Sclerosis

Objective To assess the diagnostic value of 1H magentic resonance spectroscopy （1H-MRS） in the diagnosis of multiple sclerosis （MS）. Methods 1H-MRS was carried out in 29 patients with MS and 29 cases of age-matched healthy control subjects. The areas under the peaks of the metabolites of N-acetylaspartic acid （NAA）, creatine （Cr）, choline compounds （Cho） and lactic acid （Lac） were calculated. The metabolics of NAA/（Cr＋Cho）, Cho/Cr and Lac/Cr were compared between the two groups. Results The value of NAA/Cr ＋ Cho）, Cho/Cr and LAC/Cr of MS group and control group were 0.56, 1.49, 3.35 and 0.78, 1.19, 0.23, respectively. Compared with the control group, NAA/（Cr＋Cho） reduced, Cho/Cr and Lac/Cr increased in the MS group, all of which had statistical significance （p〈0.05）. Conclusion 1H-MRS is highly specificity and can provide reliable diagnostic information for early diagnosis of MS, and may have important significance to guide clinical treatment and judging prognosis.