海马波谱在急性一氧化碳中毒及迟发性脑病中的应用  

Application of ^1H Magnetic Resonance Spectroscopy in Evaluating Acute Carbon Monoxide Poisoning and Delayed Encephalopathy

作　　者：高敏[1] 邱传亚[1] 周玉荣[1] 蒋珊珊[1] 

机构地区：[1]民航总医院放射科,北京100123

出　　处：《临床放射学杂志》2013年第6期770-774,共5页Journal of Clinical Radiology

摘　　要：目的利用磁共振波谱技术研究急性一氧化碳中毒(ACOP)患者及迟发性脑病(DEACMP)患者海马代谢物数值与正常对照组的差异,探讨其临床意义。方法所有实验者被分为3组:ACOP组17例、DEACMP组43例及正常对照组30名,并按年龄将3组分别分成年轻组(<50岁)和年老组(≥50岁)。所有病例均分别行双侧海马区磁共振波谱检查,采用单体素分辨自旋回波序列的点解析波谱法采集数据,记录双侧海马区氮-乙酰天门冬氨酸(NAA)/肌酸(Cr)、胆碱(Cho)/Cr值,采用独立样本t检验及单因素方差分析分组进行统计学分析。结果 (1)正常对照组左右两侧海马NAA/Cr、Cho/Cr差异均无统计学意义(年轻组NAA/Cr P=0.558、Cho/Cr P=0.566;年老组NAA/Cr P=0.546、Cho/Cr P=0.894)。(2)年轻组NAA/Cr数值:对照组、ACOP组、DEACMP组数值依次降低,差异有统计学意义(F=4.805,P=0.01)。(3)年轻组Cho/Cr数值依上顺序依次升高,差异有统计学意义(F=5.58,P=0.005)。(4)年老组NAA/Cr:对照组高于ACOP组与DEACMP组,差异有统计学意义(F=3.54,P=0.012);组内比较ACOP组与DEACMP组差异无统计学意义(P=0.512)。(5)年老组Cho/Cr:对照组低于ACOP组与DEACMP组,差异有统计学意义(F=3.931,P=0.026);组内比较对照组与ACOP组、ACOP组与DEACMP组差异均无统计学意义(P=0.684,P=0.479)。结论利用磁共振波谱技术可以准确反映ACOP患者急性期与迟发脑病期海马区代谢变化,为评估病情的严重性与早期诊断及预防DEACMP的发生提供理论支持。Objective To evaluate the metabolic data and its clinical value of hippocampus in acute carbon monoxide poisoning（ACOP） and delayed encephalopathy after acute carbon monoxide poisoning（DEACMP） using 1^ H magnetic reso-nance spectroscopy. Methods The subjects were divided into 3 groups： ACOP group （17 cases）, DEACMP group （43 cases） and control group （30 cases）, also the subjectes were divided into 2 subgroups according to age： younger people （ 〈 50yrs） and aged people（≥50yrs）. All subjects underwent bilateral hippocampus MRS scans. Spectrum was collected by 2D 1^H MRS point resolved spectroscopy. NAA/Cr and Cho/Cr of bilateral hippocampus were recorded. Independent sample t test and single factor analysis were used for analyse. Results （ 1 ） There was no significant statistics difference between left and right hippocampus in control group（ younger people NAA/Cr P = 0. 558, Cho/Cr P = 0. 566;aged people NAA/Cr P = 0. 546,Cho/Cr P = 0. 894）. （2） For younger people, NAA/Cr showed descended in control, ACOP and DEACMP groups, and NAA/Cr had significant difference among groups （ F = 4. 805, P = 0.01 ）. （3） For younger people, Cho/Cr showed ascended in ontrol, ACOP and DEACMP groups, and Cho/Cr had significant difference among groups, （ F = 5.58, P =0. 005）. （4）For aged people, NAA/Cr in control group was higher than that of ACOP group and DEACMP group, which had significant difference （F = 3.54,P = 0. 012） , while there was no significant difference between ACOP group and DEACMP group （P =0. 512）. （5）For aged people, Cho/Cr in control group was lower than that of ACOP and DEACMP group, which had significant difference （F = 3.931 ,P = 0. 026） , while there was no significant difference between control group and ACOP group, or between ACOP group and DEACMP group （P = 0. 684,P = 0. 479）. Conclusion MRS could precisely reflect the hippocampus metabolic changes in the patients with ACOP and DEACMP. It will provide theoretical support for cl

关 键 词：一氧化碳中毒 海马 磁共振成像 磁共振波谱 

分 类 号：R747.9[医药卫生—神经病学与精神病学]