肌萎缩侧索硬化症脑内病变的磁共振波谱研究  

To explore the degeneration in the brain of amyotrophic lateral sclerosis by MR spectroscopy

作　　者：薛艳萍[1] 翟仁友[1] 谭可[2] 顾华[1] 张芳[3] 张媛[3] 

机构地区：[1]首都医科大学附属北京朝阳医院放射科,北京100020 [2]首都医科大学附属北京朝阳医院神经外科,北京100020 [3]北京海淀医院放射科,北京100080

出　　处：《中国医学影像技术》2007年第2期201-204,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的采用1H-MRS技术,检测肌萎缩侧索硬化症(ALS)患者脑内相关代谢物NAA、Cho及Cr的含量,用以判定ALS病人的上运动神经元(UMN)是否受累。方法运用GESigna3.0T磁共振成像系统,采用点分辨波谱分析法(PRESS)行2D多体素1H-MRS扫描,沿锥体束的走行方向,定量检测ALS病人与正常人各相关脑区内NAA、Cho及Cr的含量,计算出NAA/Cr及Cho/Cr的比值,并将其与反映上运动神经元(UMN)功能的最大手指敲击率进行相关分析。结果①与性别、年龄相当的正常人相比,ALS病人的NAA/Cr比值在右侧大脑脚区、左侧内囊后肢前部及左侧中央后回处显著降低(P<0.05);②Cho/Cr比值在右侧内囊后肢后部、放射冠前、后部、中央前、后回较正常人显著增高(P<0.05);③相关分析结果显示,放射冠前部的NAA/Cr与左手的最大手指敲击率显著相关,而放射冠后部的Cho/Cr与双手平均的最大手指敲击率显著相关。结论1H-MRS技术可以检测ALS病人相关脑区NAA/Cr及Cho/Cr比值与正常人存在显著差别,提示ALS病人脑内确实存在着神经元的变性或缺失,同时表明1H-MRS技术可客观、定量地反映UMN的功能。Objective To examine whether the upper motor neuron （UMN） have been involved in amyotrophie lateral sclerosis （ALS） through investigating the change of metabolites in the brain by proton magnetic resonance spectroscopic （^1HMRS）. Methods Twenty patients with clinically probable or definite ALS according to the El Escorial criteria and 12 （age and sex matched） healthy control subjects were studied by t H-MRS on GE Signa 3. 0T MR system. Four axial planes of two-dimensional 1 H-MRS data were collected from motor cortex, corona radiata, internal capsule and cerebral peduncle. The NAA/Cr and Cho/Cr ratios were measured by 1 H-MRS. Results ①The level of the NAA/Cr ratios in ALS patients was lower than that of the normal controls in the right cerebral peduncle, left anterior of the post limb of internal capsule, and left postcentral gyrus; ②The level of the Cho/Cr ratios also increased significantly in the right posterior of the posterior limb of the internal capsule, right corona radiata and right pre-postcentral gyrus when compared with that of normal controls; ③ There was a significant relationship between maximum finger-tap rate and NAA/Cr in the anterior corona radiata, Cho/Cr in the posterior corona radiate. Conclusion The results from ^1 H-MRS suggest the distribution of neuronal loss in ALS, and ^1 H-MRS can be a quantitative measurement in the evaluation of UMN dysfunction in ALS.

关 键 词：肌萎缩侧索硬化 磁共振波谱 磁共振成像 

分 类 号：R744[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]