氢质子磁共振波谱定量分析在脑梗死可存活区研究中的应用  

The value of proton magnetic resonance spectroscopy in the analysis of final survival area in cerebral infarction

作　　者：黄丙仓[1,2] 李欢欢[1] 许晓岚[2] 弋春燕 陈杰[2] 武刚[1] 郑海宁[2] 

机构地区：[1]复旦大学附属中山医院青浦分院(上海市青浦区中心医院)放射科,上海201700 [2]上海市浦东新区公利医院医学影像科,上海200135

出　　处：《肿瘤影像学》2013年第1期19-22,共4页Oncoradiology

基　　金：上海市科技发展基金(No:114119a9700);浦东新区科技发展基金(No:PKJ2011-Y10)

摘　　要：目的应用磁共振波谱技术(MRS)观察脑梗死后主要代谢物:N-乙酰基天冬氨酸(NAA)、乳酸(Lac)、脂质(Lip)、胆碱(Cho)、肌酸(Cr)在病灶区、对侧镜像区及最终可存活区的分布状况,分析急性脑梗死代谢物的变化规律,以获得可存活区的MRS特征及评定标准。方法对32例发病时间在24 h内的急性脑梗死患者行磁共振灌注成像(PWI)和氢质子磁共振波谱成像(1H-MRS)检查方法,并在30 d后复查T2WI确定最终梗死范围,测量梗死中心区、对侧镜像区及最终可存活区的物质代谢改变。结果初检时病灶中心的NAA水平较对侧镜像区降低;Lac峰及Lip峰出现并重叠。可存活区MRS特征为:NAA水平与对侧镜像区比较差异不明显,与病灶中心比略高(差异有统计学意义);Lac水平升高,但较病灶中心区低(差异有统计学意义),可存活区未见明显Lip峰。结论应用MRS分析急性脑梗死不同区域代谢物浓度可预测急性脑梗死的最终存活区。Objective To study the characteristics of metabolites in the infarct area and final survival area by 1H-magnetic resonance spectroscopy(1H-MRS) and the metabolic changes in the acute cerebral infarction,and thereby to set the quantitative evaluation standards of final survival areaby 1H-MRS.Methods The perfusion-weighed imaging(PWI) and magnetic resonance spectroscopy(MRS) were performed in 32 patients clinically diagnosed with acute cerebral infarction within 24 h,and all the patients were followed up by T2WI to determine the final survival area.The metabolite changes were measured in the infarct area,control area,and final survival area.Results In the first test,the NAA levels of infarct center decreased compared with the control area,and the lactate peak and lipid peak appeared and overlapped.MRS characteristics of the final survival area were as follows: There was no difference in the NAA level between the final survival area and control area;The NAA level of the final survival area was significantly higher than that of the infarct center.Conclusion The final survival area of the acute cerebral infarction can be evaluated by the characteristics of metabolite changes in different areas with1H-MRS.

关 键 词：磁共振波谱 脑梗死 可存活区 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]