大脑皮质发育障碍患者磁共振波谱分析  

Magnetic resonance spectroscopy of patients with disorders of cerebral cortical development

作　　者：冯占辉[1] 吕发金[2] 黄华[1] 晏宁[1] 罗天友[2] 王学峰[1] 晏勇[1] 

机构地区：[1]重庆医科大学附属第一医院神经内科,重庆市神经病学重点实验室,重庆400016 [2]重庆医科大学附属第一医院放射科,重庆400016

出　　处：《中国医学影像技术》2009年第5期764-767,共4页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(30570636)

摘　　要：目的应用氢质子磁共振波谱(1H-MRS)探讨不同类型皮质发育障碍患者的脑代谢异常改变。方法收集诊断明确的大脑皮质发育障碍伴有癫痫发作患者20例,对照组25名健康受试者。所有受试者均进行多体素二维1H-MRS扫描。测量不同类型皮质发育障碍患者病灶区、病灶毗邻区、远离病灶区皮质NAA/Cr值,并与对照组相应区域皮质NAA/Cr值进行比较。结果局灶性皮质发育不良患者病灶区、病灶毗邻区较对照组NAA/Cr值显著降低(P<0.01);灰质异位病灶区和病灶毗邻区与对照组NAA/Cr值之间差异无统计学意义(P>0.05);脑裂畸形病灶区较对照组NAA/Cr值降低(P<0.05),病灶毗邻区与对照组NAA/Cr值之间差异无统计学意义(P>0.05);三种类型皮质发育障碍远离病灶区与对照组NAA/Cr值之间差异无统计学意义(P>0.05)。结论应用多体素二维1H-MRS能够区分不同类型皮质发育障碍脑代谢特点,从分子代谢水平为大脑DCDs的诊断提供了一种新的途径。Objective To investigate metabolite concentrations abnormalities in patients of disorders of cerebral cortical development （DCDs） accompanied with epilepsy with ^1H-MRS. Methods Twenty patients of DCDs accompanied with epilepsy and twenty-five healthy controls were collected. All of them underwent ^1H MRS scanning. The ratio of N-acetylaspartate/creatine （NAA/Cr） in 20 patients with DCDs were measured in the lesion areas, the adjacent areas and the regions remote to the visible lesions, and were compared with those of similar brain regions of 25 normal control subjects. Results The ratios of NAA/Cr significantly decreased in the lesions and adjacent areas of focal cortical dysplasia compared with the controls＇ regions （P〈0. 01）, but no significant difference was found in lesions or adjacent areas of heterotopia compared with that of controls＇ regions （P〉0.05）. The ratios of NAA/Cr decreased in the lesions of schizencephaly compared with the controls＇ regions （P〈0. 05）, whereas no significant defference of metabolite ratios was found between the adjacent areas and the normal regions of the controls （P〉0.05）. There was no significant difference of the metabolite ratios among the regions remote to the visible lesions of three kinds of DCDs and those of the controls＇ regions （P〉0.05）. Conclusion The metabolic properties of three kinds of DCDs might be distinguished with multivoxel 2D ^1H-MRS, which provides a new approach for DCDs at molecular metabolite level.

关 键 词：皮质发育障碍 癫痫 氢质子磁共振波谱 

分 类 号：R742.8[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]