颈内动脉狭窄性短暂性脑缺血发作的磁共振波谱研究  

Magnetic resonance spectroscopy in transient ischemic attack with internal carotid artery stenosis

作　　者：张世娟[1] 卢洁[2] 张苗[2] 

机构地区：[1]首都医科大学宣武医院综合内科,北京100053 [2]首都医科大学宣武医院放射科,北京100053

出　　处：《卒中与神经疾病》2009年第4期206-209,共4页Stroke and Nervous Diseases

摘　　要：目的利用磁共振波谱(1H magnetic resonance spectroscopy,1H-MRS)探讨单侧颈内动脉(internal carotid artery,ICA)重度狭窄或闭塞性短暂性脑缺血发作(transient ischemic attack,TIA)的脑代谢改变。方法28例经数字减影血管造影(digital subtraction angiography,DSA)证实为单侧ICA重度狭窄或闭塞性TIA患者,应用3.0T MRI行1H-MRS检查,测量患侧和对侧大脑半球半卵圆中心的代谢物氮-乙酰天门冬氨酸(N-acetylaspartate,NAA)、胆碱(choline,Cho)、肌酸(creatine,Cr)的波峰下面积,比较两侧各代谢物峰下面积比值NAA/Cho、NAA/Cr和Cho/Cr的差异,并观察有无乳酸(lactate,Lac)峰。结果28例单侧ICA重度狭窄或闭塞的TIA患者,1H-MRS显示患侧半卵圆中心的NAA/Cho、NAA/Cr比值显著低于病变对侧(P<0.05),Cho/Cr比值显著高于病变对侧(P<0.05),5例患者于患侧出现Lac峰。结论1H-MRS能够早期发现ICA重度狭窄或闭塞性TIA患者的脑代谢异常,对于早期治疗和判断预后具有重要价值。Objective To evaluate cerebral metabolic changes in transient ischemic attack （TIA） patients with unilateral internal carotid artery stenosis or occlusion. Methods 28 TIA patients with unilateral ICA stenosis or occlusion were diagnosed by digital subtraction angiography（DSA）. Muhi-voxel ^1H-MRS was performed by 3. 0T MR scanner. Cerebral metabolism was studied by assessing ratios of N-acetyl aspartate （NAA） to choline（Cho） and to creatine（Cr） as well as Cho to Cr in noninfarcted regions of the centrum semiovale in both hemispheres. Results In 28 TIA patients, the NAA/Cho and NAA/Cr ratios were significantly decreased in the centrum semiovale on the affected side compared with the contralateral side and the normal subjects（P〈0. 05）. However, the Cho/Cr ratio was significantly increased on the affected side compared with the contralateral side and normal control subjects （P〈0.05）. Lactate（Lac） was detected in diseased side of 5 patients. Conclusions ^1H-MRS can demonstrate the abnormal metabolic changes and plays an important role in early treatment and prognosis assessment in TIA patients with unilateral ICA stenosis or occlusion.

关 键 词：颈内动脉 狭窄 闭塞 短暂性脑缺血发作 磁共振波谱 

分 类 号：R743[医药卫生—神经病学与精神病学]