代谢综合征患者脑磁共振波谱及弥散张量成像研究  

Magnetic resonance spectroscopy and diffusion tensor imaging study of patients with metabolic syndrome

作　　者：杨杰华[1] 张尤桥[1] 周昱[1] 杨忠现[2] 郑晓红[1] 容宇[1] 陈薇[1] 

机构地区：[1]汕头大学医学院第二附属医院神经内科,汕头515041 [2]汕头大学医学院第二附属医院影像科

出　　处：《中国神经精神疾病杂志》2013年第4期202-207,共6页Chinese Journal of Nervous and Mental Diseases

基　　金：广东省科技厅基金项目(编号:2009B030801042);国家自然科学基金重点项目(编号:30930027)

摘　　要：目的应用磁共振波谱(Magnetic Resonance Spectrum,MRS)及磁共振弥散张量成像(Diffusion Ten sor Imaging,DTI)检测代谢综合征(metabolic syndrome,MS)患者的脑内代谢物、脑部各向异性(fractional anisotro py,FA)值,早期发现亚临床脑细胞损害。方法选取病程5年以上、无神经系统损害临床表现的MS患者15例为患者组,及健康体检者17名为对照组,检查一般项目(身高、体重、血压、血糖、血脂、神经功能相关量表评分),并行头颅MRI、DWI、MRS和DTI检查,测定脑部背侧丘脑、扣带回后部、侧脑室后角NAA/Cr、Cho/Cr、NAA/Cho的比值及内囊后肢、放射冠区FA值,所测得结果在患者组和对照组,以及患者组中3项代谢异常者与对照组、患者组中2项代谢异常者与对照组间进行比较。结果患者组、患者组中3项代谢异常者、患者组中2项代谢异常者NAA/Cr、NAA/Cho在背侧丘脑、扣带回后部、侧脑室后角均低于对照组,差异有统计学意义(均P<0.05),Cho/Cr在扣带回后部、侧脑室后角高于对照组,差异有统计学意义(均P<0.05)。患者组双侧内囊后肢、右放射冠区FA值均低于对照组(均P﹤0.05);患者组3项代谢异常者双侧内囊后肢及右放射冠区较对照组降低(均P﹤0.05);患者组2项代谢异常者仅右侧放射冠区较对照组降低(P﹤0.05)。结论病程5年以上的MS患者在背侧丘脑、扣带回后部、侧脑室后角的脑细胞代谢及在内囊后肢、放射冠区的神经纤维微结构已有损害。Objective In order to understand latent brain damage in the early stage, we used magnetic resonance spectroscopy （MRS） and diffusion tensor imaging （DTI） to detect the metabolic changes and fractional anisotropy （FA） val- ues in brain of patient with metabolic syndrome （MS）. Methods 15 MS patients with the course longer than 5 years and without clinical manifestation of nervous system damage and 17 healthy volunteers were recruited as the MS group and the control group, respectively. Their body height, weight, blood pressure, blood glucose, blood lipid and nerves function rating scales were measured. Then, their brains were examined using magnetic resonance imaging （MRI）, MRS and DTI. The metabolite ratios of NAA/Cr, Cho/Cr, and NAA/Cho were measured in the posterior cingulate gyrus, dorsal thalamus, and posterior part of lateral ventricle. In the meantime, FA values were measured in the posterior limb of internal capsule （PLIC） and corona radiate area （CRA）. All the values were compared between the MS group and the control group. Resuits Compared to the control group, significant declines of NAA/Cr and NAA/Cho in the dorsal thalamus, the posterior cingulate gyms and posterior part of lateral ventricle were found in the MS patients （P〈O.05）. And a significant increase of Cho/Cr in the posterior cingulate gyrus and posterior part of lateral ventricle was found （P〈O.05）. The FA values of both posterior limb of internal capsule （PLIC） and the right corona radiate area （CRA） were significant lower in the MS group than the control group （P〈0.05）. Compared with the controls, the FA values of both PLIC and the right CRA were lower in the patients with 3 abnormalities from the MS group （P〈0.05） ; the FA value of the right CRA was lower in the patients with 2 abnormalities from the MS group （P〈0.05）. Conclusions In the patients of metabolic syndrome with the course longer than 5 years, there are abnormalities of brain cell metabolism in dorsal thalamus, pos

关 键 词：代谢综合征 磁共振波谱 弥散张量成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]