氢质子磁共振波谱在海马硬化术前评定中的价值

目的　评价氢质子磁共振波谱 ( 1HMRS)在海马硬化术前评定中的价值。资料与方法　应用 3.0T磁共振扫描仪对 10例手术及病理证实为海马硬化的患者术前分别进行单体素MRS和化学位移成像 (CSI)检查。定量分析单体素MRS的N 乙酰天门冬氨酸 (NAA) / (肌酸 胆碱复合物 ) (Cr Cho)、NAA/Cr、Cho/Cr比值的差异。CSI观察NAA代谢图像上双侧海马信号强度的差别 ,并定量测量NAA值。结果　患侧的NAA/ (Cr Cho)、NAA/Cr比值均低于对侧 (P <0 .0 1,P <0 .0 5 )。以NAA/ (Cr Cho)比值为判定指标 ,8例 ( 8/ 10 )可以正确定侧。代谢浓度图显示患侧NAA的信号强度低于对侧 ,患侧NAA值明显低于对侧 (P <0 .0 1)。结论　MRS能够在体无创定量地反映出海马硬化的生化代谢异常 ,是术前评价海马硬化的一种非常有用的辅助检查方法

Preoperative Evaluation of Hippocampal Sclerosis with 1H Magnetic Resonance Spectroscopy

Objective To evaluate 1H magnetic resonance spectroscopy ( 1H MRS) in assessing hippocampal sclerosis before operation. Materials and Methods Ten patients with pathologically proved hippocampal sclerosis were enrolled in this study. Single voxel 1H MRS and chemical shift imaging (CSI) were performed on a 3.0T MRI/MRS system. The ratios of NAA/(Cho Cr), NAA/Cr and Cho/Cr were calculated. The metabolite images of NAA were surveyed in order to find the side of lower NAA signal intensity. By using an automated fitting program, quantitative estimation of NAA was carried out.Results The ratios of NAA/(Cho Cr) and NAA/Cr of the diseased side were lower than that of the opposite side (P<0.01 and P<0.05). The diseased side was correctly determined in 8 cases when the ratio of NAA/(Cho Cr) was taken as an index. On metabolite images, the signal intensity of NAA of the diseased side was lower than that of the opposite side, and NAA level of the diseased side was significantly lower (P<0.01).Conclusion MRS can non invasively provide biochemical and metabolic information. It should be considered as a valuable supplement exam for preoperative assessment of hippocampal sclerosis.