鼻咽癌放疗后靶区MRI表现正常的脑组织^1H—MRS表现  

Radiation Induced Pristine Temporal Lobe Injury： Study with 2D ^1 H-MRS

作　　者：赵继泉[1] 梁碧玲[1] 沈君[1] 朱新进[1] 

机构地区：[1]佛山市第二人民医院影像中心,广东528000

出　　处：《放射学实践》2007年第11期1176-1178,共3页Radiologic Practice

摘　　要：目的:采用二维相位编码磁共振波谱(2D1H-MRS)成像分析鼻咽癌放疗后常规MRI表现正常者双侧颞叶放疗靶区脑组织代谢改变,探讨2D1H-MRS在早期放射性脑损伤中的应用价值。方法:对31例(病例组)鼻咽癌放疗后常规MRI表现正常者共40个颞叶和23例(33个颞叶)健康成年人(对照组)均行2D1H-MRS检查,在双侧颞叶脑白质区域测量N-乙酰天门冬氨酸(NAA)、肌酸(PCr)和胆碱(Cho)值及相互间比值。结果:病例组颞叶区NAA、PCr降低,Cho升高,与对照组间差异无显著性意义(P>0.05);病例组Cho/PCr升高、NAA/Cho降低,与对照组间差异有显著性意义(P<0.05)。结论:2D1H-MRS能发现鼻咽癌放疗后常规MRI所不能显示的脑组织改变,为放射性脑损伤的早期诊断提供了一种新的影像学诊断手段。Objective：To study the possibility and practical value of two dimensional phase encoding proton magnetic resonance spectroscopy（2D l H-MRS） in the diagnosis of early radiation encephalopathy in post-radiation therapeutic nasopharyngeal carcinoma （NPC） patients with normal appearing white matter （NAWM） in both temporal lobes through the changes of target zone metabolites. Methods：Conventional MR imaging and 2D ^1 H-MRS examinations were performed in 40 temporal lobes of 31 post-radiation therapeutic NPC patients. The same examinations of 33 temporal lobes of 23 agematched healthy volunteers were collected as controls. Corresponding metabolites of the brain, namely, N-acetyl aspartate （NAA） ,creatine （Cr）, choline （Cho） and the ratios among them were measured in the white matter on both temporal lobes. Results：The values of NAA and PCr in temporal lobes of NPC patients were decreased,while that of Cho was increased. However,no remarkable significance （P〉0.05） in the differences between these values of NPC patients and those of the controls was found. The ratio of Cho/PCr was increased and that of NAA/Cho was decreased in NPC patient group. Significant difference （P〈0.05） in Cho/PCr and NAA/Cho ratios between NPC patients and controls were observed. Conclusion： 2D l H-MRS was capable of detecting the early histological changes of the brain in post-radiation therapeutic patients which were not shown with regular MRI, therefore,it provided a new imaging modality for the early diagnosis of radiation injury of the brain.

关 键 词：磁共振成像 磁共振波谱学 鼻咽肿瘤 辐射损伤 

分 类 号：R739.63[医药卫生—肿瘤]