儿童脑白质营养不良的氢质子磁共振波谱学研究

目的 探讨儿童脑白质营养不良的氢质子磁共振波谱学（＾１Ｈ ＭＲＳ）表现及其临床意义，为临床早期诊断和治疗提供帮助。方法 对８例脑白质营养不良患儿和６例对照组儿童进行了＾１Ｈ ＭＲＳ检查，对两组间各代谢产物峰下面积比的均值进行ｔ检验。结果 病例组ＮＡＡ／Ｃｒ比值明显低于对照组（Ｐ〈０．０１），而Ｃｈｏ／Ｃｒ比值较对照组升高（Ｐ〈０．０５），ｍＩ／Ｃｒ和ｍＩ／ＮＡＡ比值与对照组相比也明显升高（Ｐ〈０．０１）；ｍＩ／Ｃｒ比值升高是ＭＬＤ的显著特征；ＣＤ的ＮＡＡ浓度较对照组升高，Ｃｈｏ浓度减低。在ＭＲＩ表现正常的病例和ＭＲＩ未受 部位亦可探及明显的ＭＲＳ改变。结论 ＾１Ｈ ＭＲＳ可以无创地观察脑白质营养不良脑内异常的生化代谢改变，且它具有很高的敏感性，可先于ＭＲＩ发现脑内病变，有助于病变的确诊和鉴别诊断。

The Study of 1 HMRS Features of Children Leukodystrophies

Objective To detect the features and clinical importance of 1H MRS on children leukodystrophies and to provide an available method for diagnosis and treatment early. Methods 1H MRS examination was performed in 8 children with leukodystrophies and 6 controls and the test was done between two groups on the even ratio values of each metabolite. Results The ratio of NAA/Cr is lower in patients than in controls ( P <0 01),the ratio of Cho/Cr is higher in patients than in controls ( P <0 05),and the ratios of mI/Cr and mI/NAA are also higher in patients than in controls ( P <0 01).The prominent higher ratio of mI/Cr is the feature of MLD,and the density of NAA is higher and of Cho is lower in CD than in control.There are also conspicuous MRS changes in normal MRI patients and in non|involved regions in MRI. Conclusion 1H MRS can be used to detect noninvasively the abnormal metabolic changes in the brain of leukodystrohies,and in view of its higher sensitivity,the brain abnormalities can be found earlier than in MRI,which contributes to diagnosis and differential diagnosis. [