磁共振波谱及LCModel定量分析对缺血性脑梗死代谢物变化的研究  

Study of metabolic changes in ischemic cerebral infarction with quantitative proton magnetic resonance spectroscopy and LCModel techniques

作　　者：陈若伟[1] 郑文斌[1] 刘国瑞[1] 张海都[1] 

机构地区：[1]汕头大学医学院第二附属医院影像科,广东汕头515041

出　　处：《实用放射学杂志》2012年第1期6-10,共5页Journal of Practical Radiology

摘　　要：目的探讨缺m性脑梗死患者脑代谢物绝对浓度的变化及填演变规律。方法45例不㈣时期的缺血性脑梗死患者，行常规MRI及磁共振波谱检查，采用LCModel频谱定量软件完成代谢物绝对浓度的定斌分析。结果在超急性期，脑梗死区NAA、Cr浓度较刈侧明显下降．Cho、mI浓度略有下降。存急性期，脑梗死区NAA、Cr、Cho、ml浓度继续恩著下降。在亚急性期，NAA浓度保持托檄低水甲，与急性期相比已无显著性差异；而Cr、Cho、ml浓度继续艟著下降，与急性期相比有显著性差异。慢性期NAA、Cr、Cho、ml浓度处丁很低的水平。Lac浓度在超急性期明娃升高，剑急性刘浓度达到最高，亚急性期以后逐渐下降。结论磁共振波谱结合绝对定啭技术，能直观、准确地显示脑梗死后脑代谢物的改变及其变化规律，对研究脑梗死病理、生理变化有重要意义。Objective To study the changes of absolute metabolite concentrations in patients with different stages of ischemic cerebral infarction with quantitative proton magnetic resonance spectroscopy （ H-MRS） techniques. Methods 45 patients with different stages of cerebral infarction underwent conventional MR imaging, diffusion weighted imaging and 1H MRS. The absolute eoneentra tions of metabolites were obtained by the LCModel method . Results In tile hyperacute infarction , the mean concentrations of NAA and Cr were significantly decreased , and the mean concentrations of （＇he and mI were slightly （but no statistical significance） decreased compared with the contralateral hemisphere. Further reductions in NAA, Cr, Cho and ml concentrations were observed in acute infarcts. NAA levels were very low at acute and subacute stage, and were not statistically different between the two stages. Lactate doublet was present at the hyperacute stage and it was at highest level at the acute stage. The mean concentrations of Cr, Cho, ml and lactate at the snbacute stage fell significantly compared with acute stage. NAA, Cr, Cho and mI were at very low levels and no obvious lactate doublet could be seen in chronic infarcts. Conclusion Quantitative t H MRS techniques can sensitively reflect the dynamic changes of absolute metabolite concentrations in cerebral infarction in vivo and may be useful for the study of pathophysiology of stroke.

关 键 词：脑 脑梗死 磁共振波谱 代谢物 

分 类 号：R743.33[医药卫生—神经病学与精神病学] R445.2[医药卫生—临床医学]