质子磁共振波谱对MELAS诊断的初步评价  

Preliminary proton MR spectroscopy study in patients with MELAS

作　　者：冯逢[1] 有慧[1] 高晶[2] 李小圳[1] 孙宏毅[1] 孟春玲[1] 金征宇[1] 

机构地区：[1]中国医学科学院中国协和医科大学北京协和医院放射科,北京100730 [2]中国医学科学院中国协和医科大学北京协和医院神经科,北京100730

出　　处：《中国医学影像技术》2006年第6期822-825,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨质子磁共振波谱(1HMRS)在MELAS型线粒体脑肌病中的特点及其诊断价值。方法7例临床诊断为线粒体脑肌病的患者行MRI及1HMRS检查,分析其MRS检查技术、谱线特点、与临床实验室检查的关系。结果7例患者MRI脑内均有异常表现,异常信号主要出现在双侧枕叶、顶叶、颞叶,其中4例合并基底节受累,2例额叶轻度受累,1例合并双侧中脑大脑脚、丘脑受累,1例左侧岛叶受累;1HMRS的谱线显示6例患者病变处可检出乳酸双峰,其中3例在脑脊液中检出乳酸峰。结论在MELAS型线粒体脑肌病中1HMRS可提供额外的直接反映疾病代谢异常的信息,有助于其诊断的确立,且具有替代传统有创检测脑脊液乳酸水平方法的潜能。Objective To investigate the characteristics of spectra on proton magnetic resonance spectroscopy （^1H-MRS） and its value in patients with mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes （MELAS）. Methods Seven clinically diagnosed patients with MELAS underwent MRI and ^1H-MRS examinations. The ^1H-MRS techniques, characteristics of the spectra, and its correlation with the lab tests were analyzed. Results Cerebral abnormalities were revealed in all 7 patients on conventional MR images, and most abnormal signals appeared in bilateral occipital, parietal and temporal lobes. Basal ganglia involvement was found in 4 patients. Mild frontal lobe lesions were found in 2 cases, bilateral cerebral peduncles and hypothalami were involved in 1 case, and left insular lobe involvement was found in 1 patient. Spectra from prominent lesions in brain parenchyma showed lactate doublet peak was present in 6 patients. In 3 of them, lactate peak has also been noted in the ventricular CSF. Conclusion ^1H-MRS may provide additional information directly reflected the metabolism changes of the disorder, be helpful to establish the diagnosis, and have the potential to replace the conventional invasive method of quantifying lactate in the CSF.

关 键 词：线粒体脑肌病 MELAS 磁共振波谱学 

分 类 号：R445.2[医药卫生—影像医学与核医学] R739.41[医药卫生—诊断学]