儿童型肾上腺脑白质营养不良的2D-^1H MRSI和DTI初步应用  

Primitive Application of 2D-1H MRSI and DTI in Evaluating Children Adrenoleukodystrophy(cALD)

作　　者：肖江喜[1] 范晓颖[1] 郭雪梅[1] 谢晟[1] 王霄英[1] 蒋学祥[1] 

机构地区：[1]北京大学第一医院医学影像科,北京100034

出　　处：《实用放射学杂志》2005年第5期454-458,共5页Journal of Practical Radiology

摘　　要：目的探讨2D-MRSI和DTI在儿童型肾上腺脑白质营养不良的综合应用价值。方法对3例儿童型肾上腺脑白质营养不良患儿行2D-MRSI、DTI和常规MRI检查,比较病变区域代谢物NAA/Cho、NAA/Cr和Cho/Cr比值与ADC和FA的关系,以及它们与T2WI信号强度的相关性;测量常规MRI阴性的ALD额顶叶白质的ADC和FA值有无异常。结果病变T2WI信号强度与NAA/Cho比值和FA负相关,与ADC正相关,即T2WI信号越高,NAA/Cho越低、ADC越高及FA越低,且具有从外到内的层次性。各种代谢物比值以NAA/Cho比值与ADC和FA相关最密切。DTI不能发现常规MRI阴性的ALD白质病变。结论MRSI和DTI与常规MRI表现具有一定的相关性,2D-MRSI和DTI可为儿童型肾上腺脑白质营养不良诊断提供更多的信息。Objective To assess the utility of MRSI and DTI in evaluating children with adrenoleukodystrophy.Methods Multislice 2D-MRSI, DTI and MRI were performed in 3 patients with cALD.The relationship of the ratios of NAA/Cho, NAA/Cr and Cho/Cr to ADC and FA as well as the signal intensity of T_2WI in regions of interest were compared. In addition, ADC and FA in ALD with normal-appearing white matter on conventional MRI were evaluated.Results In the lesions, the signal intensity of T_2WI showed positive correlation with ADC and negative with NAA/Cho. The ratio NAA/Cho showed the strongest correlation with ADC and FA compared to other metabolic parameters. the ratios of NAA/Cho, ADC and FA values of the lesions showed different values at different T_2WI signal intensity: the higher the T_2WI signal intensity, the higher the ADC and lower the NAA/Cho ratio and FA. ALD revealed a zonal gradation of the values within the affected area from periphery to core. In addition, DTI could not detect the lesions in frontal and parietal lobes of ALD which were not noted on conventional MRI.Conclusion Combination of 2D-MRSI and DTI can be more helpful in recognizing the mechanism and entity of cALD, especially with the additional findings on conventional MRI.

关 键 词：扩散张量成像 氢质子磁共振波谱成像 肾上腺脑白质营养不良 

分 类 号：R445.2[医药卫生—影像医学与核医学] R742[医药卫生—诊断学]